Intra-articular and intraosseous approach to temporomandibular joint-targeted injections: a cadaveric investigation.
J Ultrasound
; 2024 Aug 08.
Article
in En
| MEDLINE
| ID: mdl-39117943
ABSTRACT
PURPOSE:
Temporomandibular joint osteoarthritis (TMJ-OA) management is complex, and several conservative and minimally invasive protocols have been proposed. Intra-articular injections of medications directed at OA have been performed, but in some cases, these medications do not directly contact the tissue lesion sites. Here, we propose a new real-time ultrasound-guided technique to inject medications directly into the subchondral bone.METHODS:
Ultrasound image screening was carried out with the point-of-care Clarius L15 device. Then, with the patient's mouth closed, a stainless-steel cannula with a concentric trocar was US-guided using an in-plane approach until the perforating tip of the internal trocar touched the lateral pole of the mandibular condyle. Then, the trocar was inserted through the medullary bone, where a posterior injection was made.RESULTS:
The technique's precision was confirmed by capturing an iodine contrast solution that imaged the medullary condyle of fresh anatomical specimens processed by computed tomography.CONCLUSION:
The proposed technique was effective in accessing the mandibular condyle subchondral bone in the inferior TMJ space for the simultaneously intra-articular (IA) and intra-osseous (IO) in-plane US-guided injections. Thus, its implementation may represent an important advance in early TMJ-OA treatment. This may be a promising approach, especially in OA cases in which the cortical bone is still preserved.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
J Ultrasound
Year:
2024
Document type:
Article
Affiliation country:
Brazil
Country of publication:
Italy