Endoscopically assisted fixation of the custom-made total temporomandibular joint prosthesis in TMJ Yang's system through a modified preauricular approach.

This article describes the experience with the endoscopically assisted fixation of the customized total temporomandibular joint (TMJ) prosthesis in TMJ Yang's system only through a modified preauricular approach. Twenty patients (23 joints) treated with the custom-made total TMJ prosthesis were retrospectively recruited. An endoscopically assisted technique was used through a modified preauricular approach to fix the mandibular component for all these patients. These reconstructions were evaluated by surgical records, clinical examinations, and radiographic observations. All patients had successful fixation of the prosthesis. No patient had permanent weakness of the facial nerve and malocclusion or any other severe complications. The mean operative time was 111 min per joint (range, 85-133 min). The average surgical bleeding was 195 ml per side. The mean follow-up period was 16.2 months (range, 5-32 months). The mean scores were 8.3 for surgical satisfaction and 9.2 for scar healing evaluation. All patients experienced positive clinical outcomes, with a mean 75.2% reduction in pain and 53.7% increase in mouth opening with significant differences (P<0.05). The endoscopically assisted TMJ reconstruction with the customized prosthesis in TMJ Yang's system through the modified preauricular approach could produce good aesthetic and functional results.