Ultrasound-guided autologous blood injection in patients with chronic recurrent temporomandibular joint dislocation

Sahil Parvez Gagnani, Yatin Rameshbhai Kholakiya, Ankit Arora, Ongkila Bhutia, Ashu Seith, Rohit Kumar Khandelwal, Ajoy Roychoudhury, Sahil Parvez Gagnani, Yatin Rameshbhai Kholakiya, Ankit Arora, Ongkila Bhutia, Ashu Seith, Rohit Kumar Khandelwal, Ajoy Roychoudhury

Abstract

Objective: To evaluate the accuracy and effectiveness of ultrasound (US) guided autologous blood injection (ABI) for the treatment of chronic recurrent TMJ dislocation.

Design: Prospective cohort study.

Setting: Centre for medical education and research.

Participants or animals specimens cadavers: Ninteen patients with chronic recurrent TMJ dislocation (Fifteen bilateral and fourteen unilateral).

Interventions: Autologous blood injected, 2ml in superior joint space (SJS) and 1 ml in peri-capsular tissue (PT) under ultra sound guidance.

Main outcome measures: Reduction in number of dislocation episodes, maximal mouth opening, pain (visual analogue scale) and TMJ sounds (present or absent) at the end of 2 weeks, 3 months, 6 months and 1 year.

Results: At 2 weeks post operatively 18 patients (95%) were asymptomatic only one patient (5%) complained of Recurrence of dislocation and was treated successfully by a 2nd injection. At subsequent follow up visits none reported dislocation.

Conclusions: US guided ABI for patients with chronic recurrent TMJ dislocations serves as an alternative, minimally invasive, highly effective and accurate modality of treatment since it includes exposure without radiation, real-time visualization of soft tissues, visualization of the needle tip advancement, local anesthetic spread relevant to the surrounding structures which can be performed on an outpatient basis.

Keywords: Autologous blood; temporomandibular joint dislocation; ultrasound guidance.

Conflict of interest statement

There are no conflicts of interest.

Copyright: © 2020 National Journal of Maxillofacial Surgery.

Figures

Figure 1
Figure 1
Preoperative mouth opening (approximately 60 mm)
Figure 2
Figure 2
Double lateral temporomandibular joint radiograph showing bilateral condyles traversing ahead of articular eminence
Figure 3
Figure 3
Ultrasound probe placed over the temporomandibular joint parallel to the zygomatic arch
Figure 4
Figure 4
Ultrasound image showing needle in the joint cavity as a hyperechoic line

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