Eminectomy

Eminectomy is a surgical procedure involving the removal of the articular eminence of the temporomandibular joint (TMJ), a joint that connects the jaw to the skull. This procedure is typically performed to treat conditions such as temporomandibular joint disorder (TMD), which can cause pain and dysfunction in the jaw joint and muscles that control jaw movement. The goal of eminectomy is to increase the range of motion in the jaw and to alleviate symptoms such as pain and locking of the jaw.

Indications

Eminectomy is indicated for patients with TMD who have not responded to more conservative treatments, such as physical therapy, medication, and oral splints. It is particularly beneficial for patients experiencing recurrent dislocation of the jaw, ankylosis (fusion of the jaw bone with the skull, leading to restricted movement), or severe degenerative changes in the TMJ.

Procedure

The eminectomy procedure is performed under general anesthesia. The surgeon makes an incision over the TMJ area to expose the articular eminence. The eminence, a bony projection on the temporal bone, is then carefully removed, allowing the jaw more freedom of movement. The incision is then closed with sutures. The surgery can be performed through various approaches, including preauricular (in front of the ear) or endaural (within the ear canal), depending on the specific case and surgeon's preference.

Recovery

Postoperative recovery involves managing pain and swelling with medication, applying ice packs, and adhering to a soft diet to minimize jaw movement and allow the area to heal. Physical therapy may also be recommended to improve jaw function and mobility. Most patients experience a significant improvement in their symptoms following the procedure, with increased jaw movement and decreased pain.

Risks and Complications

As with any surgical procedure, eminectomy carries risks, including infection, bleeding, and damage to nearby structures such as nerves and blood vessels. There is also a risk of postoperative scarring and changes in bite alignment. However, these complications are relatively rare, and the procedure has a high success rate in appropriately selected patients.

Conclusion

Eminectomy is a surgical option for treating severe TMD, especially in cases where conservative treatments have failed. By removing the articular eminence, the procedure aims to alleviate pain and improve jaw function. Patients considering eminectomy should discuss the potential risks and benefits with their surgeon to make an informed decision.