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González-García R, Monje F. Complications of temporomandibular joint arthroscopy. A critical appraisal of the literature. J Craniomaxillofac Surg 2024; 52:1122-1132. [PMID: 39030113 DOI: 10.1016/j.jcms.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 04/06/2024] [Accepted: 06/09/2024] [Indexed: 07/21/2024] Open
Abstract
To search for the best available scientific evidence in relation to the reported overall and selective complication rates for arthroscopic surgery in patients presenting with internal derangement (ID) of the temporomandibular joint (TMJ). A comprehensive electronic search was conducted without data or language restrictions up to August 2023. Inclusion criteria were the following: study in humans, randomized or quasi-randomized controlled trials (RCTs), controlled clinical trials (CCTs), cohort studies and series of clinical cases. The proposed PICOS question was: "In clinical trials and retrospective clinical series of patients treated by arthroscopy, which were the overall and selective complication rates?" Exclusion criteria were animal studies, review papers, technical reports, and in vitro studies. The Cochrane Collaboration Tool was used to assess the risk of bias of the included studies in terms of their quality. The Strength of Recommendation Taxonomy (SORT) classification was used to determine the level of evidence of the selected studies. A total of 498 studies were identified. Of these, 16 studies fulfilled the inclusion criteria and were selected for qualitative assessment. Temporary 5th nerve deficit, ranging from 0.15% to 2.38%, was reported to occur in most larger series, comprising 7394 operated joints. Temporary 7th nerve paresis was reported to occur in 0.21%-0.7% in the largest series, comprising 6866 operated joints. Partial hearing loss was reported in 6 studies, ranging from 0.21% to 2.2% in 5845 operated joints. Edema of surrounding soft tissues, including parapharyngeal, soft palate and/or preauricular edema was reported in 8 studies, with complication rates ranging from 2% to 17.9% in 2274 operated joints. Laceration of the EAC was reported in 8 studies involving 2665 operated joints, with complication rates ranging from 0.3% to 6%. A total of 872 complicated events among 11,304 operated joints were reported, accounting for an overall complication rate of 7.71%. Complications from arthroscopic procedures have been inconsistently reported, but there are a small number of retrospective studies with well-reported complications rates. As overall complication rate accounts for less than 8% of the cases, arthroscopy seems to be a highly safe procedure for the treatment of internal derangement (ID) of the TMJ. Due to the absence of studies with high evidence, information for patients about complications should be based on clinical series of cases.
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Affiliation(s)
- Raúl González-García
- Department of Oral and Maxillofacial-Head and Neck Surgery, Hospital Universitario de La Princesa, c/ Diego de León 62, Madrid, Spain.
| | - Florencio Monje
- Department of Oral and Maxillofacial Surgery, Hospital Universitario de Badajoz, Av. de Elvas s/n, Badajoz, Spain
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Terry F, Luther E, Rodriguez-Calienes A, Lopez-Calle J, Diaz-Llanes B, Quispe-Vicuna C, Saal-Zapata G, Levy AS, Padilla-Santos M, Zullo K, Cabanillas-Lazo M, Alva-Diaz C, Starke RM, Sequeiros J. Traumatic middle meningeal arteriovenous fistulas (MMAVFs): an exploratory systematic review. Neurosurg Rev 2024; 47:631. [PMID: 39289233 DOI: 10.1007/s10143-024-02757-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/08/2024] [Accepted: 08/23/2024] [Indexed: 09/19/2024]
Abstract
This study aims to systematically review case reports and case series in order to compare the postoperative course of conservative, endovascular and surgical treatments for traumatic dural arteriovenous fistulas predominantly supplied by the middle meningeal artery (MMAVFs), which usually occur following head trauma or iatrogenic causes. We conducted a comprehensive search of PubMed, Embase, Scopus, Web of Science, and Google Scholar until June 23rd, 2024. Three cohorts were defined based on the treatment modality employed. The primary outcomes were the rates of overall obliteration and postoperative complications, with all-cause mortlality considered as secondary outcome. A total of 61 studies encompassing 78 pooled MMAVFs were included in the qualitative analysis. The predominant demographic consisted of males (53.9%) with a median age of 50.5 (IQR: 33.5-67.5) years. The main etiologies for fistula formation were head trauma (75.6%), cranial neurosurgical procedures (11.5%) and endovascular embolization (8.97%). Venous drainage patterns were categorized as follows based on anatomical confluence: Class I (16.7%), II (14.1%), III (12.8%), IV (14.1%), V (7.7%), and VI (3.9%). Regarding treatment efficacy, the overall obliteration rate was 89.74%, achieved through endovascular (95.83%), surgical (64.29%) or conservative (93.75%) approaches. In terms of safety, the overall postoperative complication rate was 6.49% with an all-cause mortality rate of 8.97%, predominantly observed in the surgical group (35.71%). Our systematic review highlights the challenging management of traumatic MMAVFs, frequently associated with head injuries. Endovascular therapy has emerged as the predominant treatment modality, demonstrating markedly higher rates of fistula obliteration, reduced all-cause mortality, and fewer postoperative complications.
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Affiliation(s)
- Fernando Terry
- Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Evan Luther
- Department of Neurosurgery, Allegheny General Hospital, Pitssburg, PA, USA
| | | | | | | | - Carlos Quispe-Vicuna
- Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria - NEMECS, Universidad Científica del Sur, Lima, Perú
- Red de Eficacia Clínica y Sanitaria (REDECS), Lima, Perú
| | - Giancarlo Saal-Zapata
- Department of Neurosurgery, Endovascular Service, Hospital Nacional Guillermo Almenara Irigoyen - EsSalud, Lima, Perú
| | - Adam S Levy
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Kyle Zullo
- American University of Antigua College of Medicine, New York, NY, USA
| | - Miguel Cabanillas-Lazo
- Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria - NEMECS, Universidad Científica del Sur, Lima, Perú
- Red de Eficacia Clínica y Sanitaria (REDECS), Lima, Perú
| | - Carlos Alva-Diaz
- Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria - NEMECS, Universidad Científica del Sur, Lima, Perú
- Service of Neurology, Department of Medicine, Office of Education and Research Support, Hospital Daniel Alcides Carrion, Callao, Peru
| | - Robert M Starke
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Joel Sequeiros
- Department of Neurological Surgery, Division of CNS Endovascular Surgery, University of Louisville, Louisville, KY, USA.
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T AP, Ek J, John B, Pg A, S M, Abraham AA. Complications of arthroscopic lysis and lavage in internal derangement of the temporomandibular joint - A single institutional experience with review of literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:691-696. [PMID: 35772702 DOI: 10.1016/j.jormas.2022.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/12/2022] [Accepted: 06/26/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate the complications of arthroscopic lysis and lavage with joint sweep (ALL) procedure in the management of disc derangement of the temporomandibular joint. METHODS Patients with internal derangement of the TMJ who were treated by ALL in a tertiary institution from July 2018 to December 2021 were studied retrospectively. RESULTS The study included 39 patients (males, n = 14; females, n = 25) and 50 joints. The complications observed in the study were classified into intra and post operative complications. Post operative complications such as pain (16%), swelling (6%), reduced mouth opening (22%) and neurological complications were the most commonly observed ones. Rare complications such as ipsilateral palatal swelling (6%), parapharyngeal swelling (4%), and post operative malocclusion (2%) were also observed. CONCLUSION Although the complications of ALL are entirely unavoidable, their incidence can be reduced by strict adherence to standard techniques. Three-dimensional awareness and orientation of the dangerous angles and depth around the TMJ region is mandatory to reduce the complications.
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Affiliation(s)
- Anish Poorna T
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, Kerala, India.
| | - Joshna Ek
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, Kerala, India
| | - Bobby John
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, Kerala, India
| | - Antony Pg
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, Kerala, India
| | - Mohan S
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, Kerala, India
| | - Abin Ann Abraham
- Department of Oral and Maxillofacial Surgery, Al Azhar Dental College, Kerala, India
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Nazari P, Golnari P, Sukumaran M, Shaibani A, Hurley MC, Ansari SA, Potts MB, Jahromi BS. Spontaneous Thrombosis of a Middle Meningeal Arteriovenous Fistula With Subsequent Pseudoaneurysm Formation: Case Report and Review of Literature. NEUROSURGERY OPEN 2020. [DOI: 10.1093/neuopn/okaa006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
ABSTRACT
BACKGROUND AND IMPORTANCE
Middle meningeal artery (MMA) pseudoaneurysms and middle meningeal arteriovenous fistulas (MMAVFs) are rarely reported after head injury. We report an unusual case of delayed MMA pseudoaneurysm formation after spontaneous thrombosis of an MMAVF, and review existing literature on MMAVF treatment and results.
CLINICAL PRESENTATION
A 59-yr-old male presented with a 5-d history of worsening left-sided headaches, followed by nausea, lethargy, and difficulty with speech. Non-contrast computed tomography demonstrated a left temporal intraparenchymal hemorrhage (IPH) and an acute left-sided subdural hematoma (SDH). Cerebral angiography found abnormal shunting between the right MMA and the right sphenoparietal sinus, consistent with an MMAVF. During the course of admission, the patient's neurological condition deteriorated requiring craniotomy for evacuation of SDH and IPH. Given the presumed incidental nature of the contralateral MMAVF, conservative management was recommended. Follow-up imaging 2 mo after surgery revealed spontaneous thrombosis of the right MMAV. Repeat imaging 5 mo later revealed an MMA pseudoaneurysm at the prior fistulous site, which was subsequently embolized with Onyx, occluding the pseudoaneurysm and the MMA both proximal and distal to the pseudoaneurysm.
CONCLUSION
Spontaneous thrombosis of an MMAVF is rare and only seen in 13.1% of cases. However, subsequent delayed formation of an MMA pseudoaneurysm has not been described. Our case therefore demonstrates that MMAVF thrombosis may not indicate complete healing of the underlying injury to the MMA, and suggests the need for continued follow-up of such lesions despite initial apparent resolution.
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Affiliation(s)
- Pouya Nazari
- Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Pedram Golnari
- Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Madhav Sukumaran
- Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ali Shaibani
- Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Michael C Hurley
- Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sameer A Ansari
- Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Matthew B Potts
- Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Babak S Jahromi
- Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Tokairin K, Osanai T, Kazumata K, Sawaya R, Houkin K. Contrecoup Injury-Induced Middle Meningeal Arteriovenous Fistula Detected by Time-of-Flight Magnetic Resonance Angiography and Magnetic Resonance Arterial Spin Labeling: Case Report and Review of the Literature. World Neurosurg 2019; 127:79-84. [PMID: 30928586 DOI: 10.1016/j.wneu.2019.03.189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Middle meningeal arteriovenous fistula (MM-AVF) is rare; however, it will sometimes be followed by intracranial hemorrhage or progressive symptoms caused by abnormal shunt flow. Radiological examination and endovascular treatment of this condition have recently advanced; thus, we have described the pathogenesis, clinical features, and appropriate diagnostic and therapeutic management of MM-AVF. We also reviewed the reported data of the past 35 years, including 30 cases of MM-AVF. CASE DESCRIPTION We report the case of 24-year-old man who had presented with right tinnitus who had experienced previous head trauma on the opposite side to the tinnitus ear. Time-of-flight magnetic resonance angiography and magnetic resonance arterial spin labeling findings were suggestive of MM-AVF, and catheter angiography confirmed MM-AVF with shunt flow draining into the cavernous sinus. Endovascular transarterial embolization was performed, and the MM-AVF was embolized successfully using detachable coils and n-butyl-2-cyanoacrylate. The tinnitus disappeared completely immediately after the treatment. CONCLUSIONS MM-AVF is caused, not only by coup injury, but also by contrecoup injury. Time-of-flight magnetic resonance angiography and magnetic resonance arterial spin labeling are useful for detecting MM-AVF. Endovascular transarterial embolization is an effective and safe treatment.
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Affiliation(s)
- Kikutaro Tokairin
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
| | - Toshiya Osanai
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ken Kazumata
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ryosuke Sawaya
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kiyohiro Houkin
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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The Hybrid Technical Management of Large and Complicated Traumatic Arteriovenous Fistula of Preauricular Region. J Craniofac Surg 2017; 29:432-436. [PMID: 29227408 PMCID: PMC5865499 DOI: 10.1097/scs.0000000000004138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Arteriovenous fistula (AVF) is defined as an abnormal communication between the high flow arterial system and the low flow venous network, which directly connects the arterial feeding vessels and the near draining veins without normal intervening capillary bed. Arteriovenous fistula incurs in preauricular region is exceeding rare. Most of these fistulae occur as a result of an iatrogenic injury, the volume is small, feeding and draining vessels of feeding and draining are simple, and can be cured easily. However, the treatment of the large and complicated AVF after incidental trauma in preauricular region is a challenge even for senior neurosurgeon. In this study, the authors discuss the management of a traumatic AVF through combined therapeutic method of surgical ligation and transarterial embolization. It is fed by ipsilateral superficial temporal artery, internal maxillary artery, posterior auricular artery, and their accessory branches and is drained by ipsilateral common facial vein and external jugular vein. Also the etiology, clinical manifestations, pathology, diagnosis, and management are summarized. Conclusion: Large and complicated traumatic AVF in preauricular region is rare, often due from an injury in maxillofacial region, combined therapy needed.
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Mettu P, Bhatti MT, El-Dairi M, Price EB, Lin AY, Alaraj A, Setabutr P, Moss HE. Orbito-Masticatory Syndrome. J Neuroophthalmol 2016; 36:308-12. [PMID: 26919071 PMCID: PMC4772138 DOI: 10.1097/wno.0000000000000354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We describe 2 unique cases of visual symptoms occurring during mastication in patients with lateral orbital wall defects. A 57-year-old man reported intermittent double vision and oscillopsia after a right fronto-temporal-orbito-zygomatic craniotomy with osteotomy of the lesser wing of the sphenoid for a complex invasive pituitary adenoma. Proptosis of the right globe was present only during mastication. Computed tomography (CT) revealed a bony defect in the right lateral orbital wall. A 48-year-old man presented with transient diplopia and scotoma in the right eye elicited by chewing. CT and magnetic resonance imaging demonstrated a bilobed lesion connecting the temporal fossa to the orbit through a defect in the right lateral orbital wall. The regional neuroanatomy and pathophysiology as pertaining to these cases are discussed.
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Affiliation(s)
- Pradeep Mettu
- Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, USA
| | - M. Tariq Bhatti
- Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, USA
- Department of Neurology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Mays El-Dairi
- Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, USA
| | - Evan B. Price
- Department of Ophthalmology, Loyola University Chicago, Maywood, Illinois, USA
| | - Amy Y. Lin
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ali Alaraj
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Pete Setabutr
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Heather E. Moss
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Neurology & Rehabilitation, University of Illinois at Chicago, Chicago, Illinois, USA
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Cariati P, Marin-Fernandez AB, Monsalve-Iglesias F, Roman-Ramos M, Garcia-Medina B. Traumatic arteriovenous fistula as consequence of TMJ arthroscopic surgery. A case report. J Clin Exp Dent 2016; 8:e352-4. [PMID: 27398189 PMCID: PMC4930648 DOI: 10.4317/jced.52954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 01/21/2016] [Indexed: 11/05/2022] Open
Abstract
UNLABELLED The ocurrence of a traumatic arteriovenous fistula after arthroscopic surgery of TMJ represents an extremely rare event. Specifically, this uncommon complication has been described only in a few case reports. In this light, the most frequent symptoms showed by this disease are thrills, bruits, pulsatile tinnitus, and an expansible vascular mass. Importantly, the severity of these symptoms is also dependent on the vessels involved. With regard to the management, is important to note that the vessel ligation with surgery as well as vessel emolization with endovascular procedures have been shown to be effective in the treatment of these cases. In view of that, the present study describes a case of superficial temporal arteriovenous fistula that arose as a postoperative complication of a bilateral arthroscopic eminoplasty of TMJ. The aim of the present report is to characterize this rare syndrome with the goal of proposing suitable treatments. KEY WORDS Arteriovenous fistula, arthroscopic surgery, eminoplasty of TMJ, temporal vessels.
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Affiliation(s)
- Paolo Cariati
- Oral and Maxillofacial surgery resident. Hospital Universitario Virgen de las nieves, Granada, Spain
| | | | | | - Maria Roman-Ramos
- Oral and Maxillofacial surgery resident. Hospital Universitario Virgen de las nieves, Granada, Spain
| | - Blas Garcia-Medina
- Maxillofacial Surgeon. Hospital Universitario Virgen de las nieves, Granada, Spain
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