TMJ Arthrocentesis
This is a minimally invasive procedure that is used to help reduce joint pain and improve jaw function. The upper joint space is washed out and medication is injected to reduce the inflammation in the TMJ.
IV Sedation
Because of the delicate nature of the procedure and the site, the procedure is usually undertaken under IV sedation which minimises unsafe patient movements. The procedure generally last anywhere around 15-20 minutes.
Procedure
Multiple small needles are inserted in front of the ear that heals and disappears completely in a few days. The joint is then thoroughly washed out to reduce the inflammatory chemicals and minute debris that may be responsible for the symptoms of pain and joint dysfunction. Small needles may also be used to help break up the scar tissue.
What to Expect
The jaw joint will be swollen and sore for up to 5-7 days although the most significant swelling and soreness usually starts subsiding after the first 24 hours. Pain medications will be prescribed and these should be taken on a regular basis as instructed on the packet.
Because of the swelling, the ear on the side where the surgery is performed may feel stuffy and blocked for up to 2 weeks after which it disappears. The bite may also feel a little different but this too will return to normal as the swelling subsides.
Bleeding is unusual following temporomandibular joint arthrocentesis. If the wound oozes or bleeds rest quietly with your head elevated and place a pressure pack over the wound. If bleeding persists beyond 30 minutes please contact Dr Kim’s rooms.
Soft Diet
It is important that the patient maintains a soft non-chewing diet for the first 2 weeks after the procedure to allow healing of the joint tissues.
Splint
If you are currently undergoing splint therapy, the splint may not fit comfortably in the first 2 weeks after surgery because of the swelling and the bite change. If so then it is best to wait until after seeing Dr Kim. For those patients without a bite splint, Dr Kim may recommend one be fitted after the procedure depending on the patient’s progress and prognosis.
Physiotherapy
Dr Kim may recommend physiotherapy for patients with limited mouth opening.
Possible Side-Effects or Complications
Complications following TMJ arthrocentesis are uncommon. Infection of the puncture site may present as a draining sinus in front of the ear which requires immediate attention by Dr Kim. Transient weakness of the facial nerve may present with the inability to properly shut the eye or lift the eyebrow on the affected side. This is usually mild and heals completely within 24 hours. Numbness around the ear, temple and cheek may also be experienced by some patients and will often resolve spontaneously in due course. Ear infection, bleeding and partial deafness are also uncommon.
Will Arthrocentesis Permanently Cure My Jaw Joint Problem?
TMJ arthrocentesis on its own is rarely curative and cannot reverse or “fix” degenerative jaw joints. Degenerative TMJ is much more likely to need further surgery in the future than a non-degenerative joint.
If TMJ arthrocentesis fails to improve the condition of the jaw joint within 3 months, then Dr Kim will discuss other options including TMJ arthroscopy and/or open joint surgery such as TMJ replacement.
Queries
If any problems or queries arise please contact Dr Samuel Kim’s rooms.