Minimally Invasive Oral and Maxillofacial Surgery

Description:

Minimally invasive techniques, designed to reduce morbidity and risk while simultaneously improving outcomes, are increasingly being used in oral and maxillofacial surgery. This book covers the most recent technological developments and the advanced techniques used when performing such minimally invasive surgery in patients with common and rare oral and maxillofacial pathologies. The relevant basic science is reviewed, but the principal focus is on the surgical techniques themselves. These are described step by step with the aid of numerous superb color illustrations that will help the clinician to gain a full understanding of the technology and the procedures. In addition, still emerging techniques of endoscopy, navigation, and minimally invasive surgery are well covered. This text will be a premier resource for physicians who diagnose and treat oral and maxillofacial pathologies and injuries.

Contributors

1: The History of Minimally Invasive Approach in Oral and Maxillofacial Surgery

1.1 Introduction

1.2 The Development of Endoscopy

1.3 What About the Maxillofacial Area?

1.4 Intraoperative Navigation in Oral and Maxillofacial Surgery

1.5 Distraction Osteogenesis and Tissue Engineering

References

2: Modern Temporomandibular Joint Arthroscopy: Operative Single-Cannula Arthroscopy

2.1 History and Goals

2.2 Anatomy of the Temporomandibular Joint Region

2.3 Temporomandibular Joint Disorders

2.3.1 Diagnosis

2.3.2 Classifications

2.3.3 Conservative Treatment

2.4 Arthroscopy

2.4.1 Indications for Arthroscopy

2.4.2 Contraindications for Arthroscopy

2.4.3 Armamentarium

2.4.3.1 The Arthroscope

2.4.3.2 Cannulas

2.4.3.3 Probes

2.4.3.4 Graspers and Biopsy Forceps

2.4.3.5 Spinal Needles

2.4.3.6 Laser

2.5 The Operative Single-Cannula Arthroscopy Technique

2.5.1 One-Track Arthrocentesis

2.5.2 Standard Arthrocentesis Under Diagnostic Visualization

2.5.3 Visually Guided OSCA

2.5.4 Surgical Interventions Using the OSCA Technique

2.5.4.1 Anterior and Posterior Recess Adhesion Release

2.5.4.2 Synovectomy

2.5.4.3 Anterior Release

2.5.4.4 Posterior Scarification/Contracture

2.5.5 Advantages and Disadvantages of OSCA

2.5.6 Intra-articular Delivery of Medications via OSCA

2.5.6.1 Steroids

2.5.6.2 Botulinum Toxin A

2.5.6.3 Hyaluronic Acid

2.5.6.4 Platelet Concentrates

2.5.7 Post-OSCA Patient Management

2.5.7.1 General Anesthesia Considerations

2.5.7.2 Anti-inflammatory and Pain Management

2.5.7.3 Antibiotics

2.5.7.4 Diet

2.5.8 Complications of Traditional Arthroscopy and OSCA

2.5.8.1 Scuffing of Fibrocartilage

2.5.8.2 Damage to the VII Cranial Nerve

2.5.8.3 Damage to the V Cranial Nerve

2.5.8.4 Damage to the VIII Cranial Nerve

2.5.8.5 Damage to Vessels and Hamartosis

2.5.8.6 Perforation of the Glenoid Fossa

2.5.8.7 Instrument Failure

References

3: Arthrocentesis: A Minimally Invasive Approach to the Temporomandibular Joint

3.1 Introduction

3.2 The Incentives for Using the Minimally Invasive Approach for Temporomandibular Disorders

3.2.1 TMJ Integrity

3.2.2 TMJ Lubrication

3.2.3 TMJ Load Attenuation

3.2.4 TMJ Condyle Remodeling Potential

3.3 Mechanical Challenges to Joint Integrity

3.4 Temporomandibular Joint Arthrocentesis: Technique

3.5 Mode of Action

3.6 Patient Evaluation

3.6.1 Patient Self-Assessment and Clinical Examination

3.6.2 Imaging

3.7 The Role of Arthrocentesis in Various TMJ Disorders

3.7.1 The Clicking Joint

3.7.2 Limited Mouth Opening

3.7.2.1 Disc Displacement Without Reduction

3.7.2.2 Anchored Disc Phenomenon (Figs. 3.13 and 3.14)

3.7.3 Symptomatic Osteoarthritis

3.7.4 Open Lock

3.7.5 Hemarthrosis

3.7.6 Autoimmune Inflammatory Arthritis

References

4: Endoscopic Approach to Temporomandibular Fractures

4.1 Introduction

4.2 History

4.3 Technique

4.3.1 Transoral Approach

4.3.2 Transcervical Technique

4.3.3 Transoral vs. Transcervical Approaches: Technical Advantages and Disadvantages

4.4 Case Selection

4.4.1 Complications

References

5: Minimally Invasive Approach to Orbital Trauma

5.1 Introduction

5.2 Surgical Anatomy of the Orbit

5.3 Indications for Surgery After the Orbital Trauma

5.4 Surgical Approaches and Reconstruction Materials

5.4.1 Reconstruction Materials

5.4.2 The Minimally Invasive Revolution

5.5 The Endoscopic Reconstruction of Orbital Floor Fractures

5.5.1 The Operative Technique

5.5.2 Specific Approaches to Various Cases

5.5.2.1 Illustrative Case 1

5.5.2.2 Illustrative Case 2

References

6: Applications of Distraction Osteogenesis in Oral and Maxillofacial Surgery

6.1 Introduction

6.2 Mandibular Distraction

6.3 Maxilla and Midface Distraction

6.4 Deficient Alveolar Bone

References

7: Minimally Invasive Orthognathic Surgery

7.1 Introduction

7.2 Minimally Invasive Orthognathic Surgery

7.3 Navigation-Assisted Le Fort I  Osteotomy

References

8: Salivary Gland Endoscopy and Minimally Invasive Surgery

8.1 Introduction

8.1.1 Anatomical Considerations

8.1.2 Salivary Gland Disorders for Minimally Invasive Surgery

8.1.3 The Tool #1: Sialoendoscope

8.1.4 The Tool #2: Extracorporeal Shock-Wave Lithotripter

8.2 The Types and the Technique of the Minimally Invasive Interventions

8.2.1 Sialoendoscopic Removal of the Stones

8.2.2 Irrigation During Sialoendoscopy

8.3 Techniques of Endoscopic Sialolithotomy

8.3.1 Endoscopy-Assisted Intraoral Surgery

8.3.2 Ductal Stretching

8.3.3 Extraoral Approach to Parotid Stones

8.3.4 Endoscopic Sialolithotomy Face-Lift Approach

8.3.5 The Skin Incision Technique

8.3.5.1 Extracorporeal Shock-Wave Lithotripsy

8.3.6 Combination of ESWL and Sialoendoscopic Approach

8.4 The Author’s Approaches to Various Cases

8.5 Non-calculus-Related Obstruction Pathology

8.6 Complications of Sialoendoscopy and How to Avoid Them

References

9: Extracapsular Dissection for Benign Parotid Tumours

9.1 History of Parotid Surgery

9.2 Incidence of Parotid Tumours

9.3 Surgical Technique Approaches and Traditional Nerve Dissection

9.4 Extracapsular Dissection

9.4.1 Indications: Case Selection

9.4.2 ECD Technique

9.4.3 Results and Meta-Analysis

9.5 Recurrence in Pleomorphic Adenoma

References

10: Minimally Invasive Implant Surgery with and Without Sinus Floor Elevation

10.1 Introduction

10.2 The Tools: The Dental Endoscope and the DIVA Smart Implant

10.2.1 The Dental Endoscope

10.2.2 The DIVA Smart Implant (Upheal Dental Ltd., Netanya, Israel)

10.3 Endoscopy in the Implant Surgery Without Sinus Floor Elevation

10.3.1 Combined Endoscopic and Computerized Guided Implant Surgery

10.3.2 Future Perspective

10.4 When and Why the Maxillary Sinus Floor Elevation/Augmentation Is Needed?

10.4.1 Anatomy and Physiology of the Maxillary Sinuses

10.4.2 The Bone Quantity/Bone Quality Issues

10.5 Indications and Contraindications for the Sinus Floor Elevation

10.6 Endoscopy and the DIVA Implant in the Implant Surgery with the Maxillary Sinus Floor Ele

10.6.1 Techniques and Modifications of Sinus Lift Surgery

10.7 Endoscopic-Assisted SFE

10.7.1 The Dynamic Implant Valve Approach

10.8 Preoperative Planning

10.9 The Crestal Incision

10.10 Osteotome Technique (OSFE)/Transalveolar Approach/Crestal

10.11 Direct Endoscopic Evaluation (Optional)

10.12 Implant Insertion and Sinus Membrane Elevation

10.13 Injection of Grafting Material as Needed

10.14 Postoperative Care and Follow-Up

10.15 Second-Stage Surgery and Prosthetic Loading

10.15.1 Complications

10.16 Alternatives to Performing a Sinus Lift

10.16.1 Short Implants

10.16.2 Tilted Implants

10.16.3 Zygomatic and Pterygoid Implants

10.16.4 Onlay Bone Graft

References

11: Tissue Engineering as a Minimally Invasive Method

11.1 Introduction

11.2 The Concept of Cell Homing and Endogenous Tissue Engineering

11.3 Current Applications of Therapeutic Tissue Regeneration by Endogenous Stem Cell Homing

11.3.1 Periodontal Regeneration

11.3.2 Musculoskeletal Tissue Regeneration

11.3.3 Treatment of Cardiovascular Diseases

11.4 Cell Homing Devices and In Vitro Design

11.4.1 Bioscaffolds for Cell Homing

11.4.2 Navigation Cues and Niche Signals

11.4.3 Release Technology

11.5 Novel Biomaterials

11.5.1 Modified Hydrogels

11.5.2 Shape Memory

11.5.3 Extracellular Matrix Derivatives

11.6 Endoscopic and Arthroscopic Techniques for Cell Delivery in TE/RM

11.7 Transplantation of Organ Germs: Salivary Glands

References

Index