TMJ arthroscopy is a procedure that is a little more involved and invasive than an arthrocentesis done with two hypodermic needles. This procedure is almost always done in an outpatient facility in the hospital. An arthroscope is used to look inside your joint to see what is causing your problems. Some surgeons will not only look inside and wash out the joint, but also perform surgical procedures like removing scar tissue, smoothing the bone and even attempt repositioning the disc.
You will be checked in prior to your surgery time and an IV will be started. The anesthesiologist will visit and take a look at your mouth opening and discuss the anesthetic procedure. Usually, before the surgery, the surgeon will visit you to discuss what he will be doing and what it will be like when you wake up. You should have had a pre-operative appointment to discuss all of this information, so this is just to make sure you have no additional questions. Don’t hesitate to ask any questions you may have. No question is a dumb question.
After this, the anesthesiologist or nurse will probably give you some medicine to help you relax, and then, you are off to the operating room. You might remember this or you might not. If you do, you will notice that the room is very cold and that there are a lot of people buzzing around getting ready for your surgery. Take a deep breath and close your eyes- try not to let it bother you. After all, they are all there to make sure you are okay. If at any point you aren’t, speak up!
When you wake up, you will be in the recovery room. You might feel pain in your jaw joint from the surgery. Please let the nurses know if you are in pain, because they are there to give you medication and make sure you are comfortable.
Recovery time from this surgery is several days to a week. You will probably want to take off from work for three days or so, but make sure the time off is flexible in case you need extra time. Your surgeon may tell you to maintain your soft diet for a few weeks. After several days, you will probably start jaw exercises or physical therapy.
As with all surgeries, there are advantages and disadvantages to this procedure. It does allow the surgeon to look into the joint and remove any adhesions or any other pathologic tissue. The recovery is shorter and easier than with an open joint procedure and the scar is smaller (virtually undetectable). However, this surgery takes longer than an arthrocentesis done with only hypodermic needles and requires general anesthesia. Also, many studies have reported that arthrocentesis with hypodermic needles can be equally successful as arthroscopy. Because of this, and the fact that arthrocentesis with needles is so much easier to perform, many surgeons may advise doing that first.
As with all invasive procedures, we recommend exhausting all conservative options first and getting independent opinions before submitting to any surgery.