Year : 2020

Volume : Volume 11

Issue : Issue 3

Address for correspondence :
Dr. Sheeri Sabir
drsheerisabir28@gmail.com

Abstract

Background:  The aim of the study was to improve safety and visibility in the surgical approach to the temporomandibular joint (TMJ). Conventional surgical approaches to the TMJ, the facial nerve remains at risk for transient or permanent facial nerve damage. The deep subfascial approach provides an additional layer of protection (the deep layer of the temporalis fascia and the superficial temporal fat pad) to the temporal and zygomatic branches of the facial nerve and thus, is the safest method to avoid facial nerve injury.  Material and Methods: To assess facial nerve injury (FN) following TMJ surgery using deep Subfascial approach and measuring it on House and Brackman facial nerve grading system (HBFNGS). A randomized study was conducted from JANU 2019 to DEC 2020 on 17 patients with unilateral and bilateral TMJ ankylosis at Department of Dentistry IGIMS, Patna. All patients were evaluated objectively for facial nerve injury using with House and Brackmann facial nerve injury grading system post-operatively and subjectively in the various time periods, i.e. 24 hours, 1month, and 6 months.  Results: Brackman facial nerve grading system at 24 hours post operatively– in the deep subfascial approach group, 94.7% of patients (16 cases) had Grade 1 injury and 5.8% (1case) had Grade 3 injury. The condition improved with time with full recovery of facial nerve injury (FN) at all surgical sites at 6 months.  Conclusion: The Deep Subfascial approach has a distinct advantage over the conventional approaches when dissecting the temporal region and is the safest method to avoid injury to facial nerve injury (FN).

Keywords: Temporomandibular Joint ankylosis; Deep subfascial; Nerve injury.