Step 7 Exposure of the Temporomandibular Joint andor Mandibular Condyle Ramus

Cure For Tmj, Bruxing And Tooth Grinding

Best Cures for Bruxism

Get Instant Access

Access to the TMJ region may be accomplished by dissection below the zygomatic arch, as described in Chapter 12. Exposure of the lateral surface of the mandibular subcondylar region and ramus may commence lateral to the capsule of TMJ. An incision through the periosteum just inferior to the insertion of the TMJ capsule at the condylar neck will expose the neck of the condyle.

Wider access below the zygomatic arch can be enhanced with two maneuvers. In the first approach, the masseter muscle is cut or released from its origin along the zygomatic arch and body, and then stripped from the lateral surface of the mandibular ramus to expose the ramus of the mandible (Fig. 6-22). The temporalis muscle at the depth of this dissection may be noted at it inserts into the coronoid process. Another approach is to perform an osteotomy of the zygomatic arch, leaving it pedicled to the masseter muscle, and to dissect between the masseter and temporalis muscles, stripping the masseter from the lateral surface of the mandibular ramus. One anatomic consideration is valid with either of these wide exposure methods. The vascular and neural supply to the masseter muscle courses from the medial side of the mandible through the sigmoid notch into the masseter muscle. Therefore, stripping the masseter from above may severely affect its function.

Affaire Simpson

Figure 6-22 Anatomic dissection showing exposure of the superior portion of the mandibular ramus through the coronal approach. In this dissection, the masseter muscle (MM) was stripped from its origin along the undersurface of the zygomatic arch (ZA). The facial nerve is retracted inferiorly and anteriorly. Note the temporomandibular joint (TMJ) capsule, which has not been entered. The temporalis muscle (TM) is still attached to the coronoid process (CP) and the medial surface of the mandible.

Figure 6-22 Anatomic dissection showing exposure of the superior portion of the mandibular ramus through the coronal approach. In this dissection, the masseter muscle (MM) was stripped from its origin along the undersurface of the zygomatic arch (ZA). The facial nerve is retracted inferiorly and anteriorly. Note the temporomandibular joint (TMJ) capsule, which has not been entered. The temporalis muscle (TM) is still attached to the coronoid process (CP) and the medial surface of the mandible.

Was this article helpful?

0 0
How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

Get My Free Ebook


Post a comment