Step 7 Closure

The joint spaces are irrigated thoroughly and any hemorrhage is controlled before closure. The inferior joint space is closed with permanent or slowly resorbing suture by suturing the disk back to its lateral condylar attachment (Fig. 12-14). The superior joint space is closed by suturing the incised edge with the remaining capsular attachments on the temporal component of the TMJ (Fig. 12-15). If no such attachments were left attached to bone, the capsule can be resuspended over the zygomatic arch to the temporalis fascia.

Figure 12 13 Incision through the lateral attachment of the temporomandibular joint disk, entering the inferior joint space.
Figure 12 14 Closure of the inferior joint space using running suture between lateral disk attachments and the joint capsule.
Figure 12 15 Closure of the superior joint space using running suture between remnants of the temporomandibular joint (TMJ) capsule on the zygomatic arch and the TMJ capsule below.

Subcutaneous tissues are closed with resorbable sutures. No sutures deeper than subcutaneous tissues are required. The skin is then closed. A running subcuticular suture makes removal simple and allows a delay in removal if necessary (Fig. 12-16). A pressure dressing is

Subcutaneous tissues are closed with resorbable sutures. No sutures deeper than subcutaneous tissues are required. The skin is then closed. A running subcuticular suture makes removal simple and allows a delay in removal if necessary (Fig. 12-16). A pressure dressing is

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