Abstract: Objective    To evaluate the therapeutic effect of minimal tragus incision applied in temporomandibular joint disc anchorage（TMJ-DA）. Methods    The clinical and imaging data of 21 patients（27 sides）with anterior disc displacement without reduction（ADDWoR）who underwent TMJ-DA with a minimal tragus incision were retrospectively analyzed. The maximal mouth opening（MMO），maximal protrusive movement（PM），left/right maximal lateral movement（LLM/RLM），visual analogue scale（VAS）pain score，disc length，condylar height and the Fricton indexes ［ including mandibular movement（MM），joint noise（JN），joint palpation（JP），muscle palpation（MP），dysfunction index（DI），palpation index（PI）and craniomandibular index（CMI）］ were compared preoperatively and at six months postoperatively. Additionally，the efficacy of disc reposition was evaluated. Results    Twenty-one patients exhibited significant improvements in MMO，PM，LLM and RLM at six months after surgery［being（41.33 ± 3.06）mm，（9.09 ± 0.89）mm，（10.09 ± 1.09）mm，and（9.95 ± 1.20）mm］compared with those before operation［being（32.05 ± 6.29）mm，（6.90 ± 1.81）mm，（7.95 ± 2.36）mm，and（7.57 ± 2.27）mm ］（all P < 0.05）. Additionally，compared to preoperative levels，the VAS pain score and Friction indexes（excluding JN）showed a significant decrease at six months after surgery（all P < 0.05）. MRI examination results indicated that 85.2%（23/27）of the disc reposition effects were rated as excellent，while 14.8%（4/27）were rated as good. The disc′s length at six months after surgery was significantly increased［post-operation：（9.29 ± 1.35）mm；pre-operation：（7.62 ± 1.44）mm］（t = -7.293，P < 0.001），while there was no significant difference in condylar height between before surgery and at six months after surgery（t = -1.468，P = 0.154）. Conclusion    TMJ-DA can be performed through the minimal tragus incision，and it is an effective method for reposition of temporomandibular joint disc，which improves MMO，relieves pain and restores the TMJ function.

Key words: temporomandibular joint, anterior disc displacement without reduction, temporomandibular joint disc anchorage, minimal tragus incision

摘要： 目的    评价应用耳屏小切口行颞下颌关节盘锚固术的治疗效果。方法    选取2023年1—12月于空军军医大学口腔医院颌面外科就诊并应用耳屏小切口行颞下颌关节盘锚固术治疗的21例颞下颌关节盘不可复性前移位患者（27侧术区）的临床和影像学资料行回顾性分析。比较患者术前及术后6个月的最大张口度、前伸运动度、左侧方运动度、右侧方运动度、视觉模拟评分量表（VAS）疼痛评分、Friction颞下颌关节紊乱指数［包括下颌运动（MM）、关节杂音（JN）、关节触压诊（JP）、肌肉压诊（MP）、功能障碍指数（DI）、肌肉压痛指数（PI）和关节紊乱指数（CMI）］、关节盘长度及髁突高度，并评价关节盘复位效果。结果    21例患者术后6个月最大张口度、前伸运动度、左侧方运动度、右侧方运动度依次为（41.33 ± 3.06）、（9.09 ± 0.89）、（10.09 ± 1.09）、（9.95 ± 1.20）mm，分别较术前［（32.05 ± 6.29）、（6.90 ± 1.81）、（7.95 ± 2.36）、（7.57 ± 2.27）mm］明显增加，差异均有统计学意义（均P < 0.05）；与术前相比，术后6个月VAS疼痛评分、Friction颞下颌关节紊乱指数（除JN外）均降低，差异均有统计学意义（均P < 0.05）。MRI检查结果显示，85.2%（23/27）的关节盘复位效果为优，14.8%（4/27）的关节盘复位效果为良。术后6个月关节盘长度为（9.29 ± 1.35）mm，较术前［（7.62 ± 1.44）mm］明显增加，差异有统计学意义（t = -7.293，P < 0.001）；术前与术后6个月髁突高度比较，差异无统计学意义（t = -1.468，P = 0.154）。结论    应用耳屏小切口行颞下颌关节盘锚固术治疗颞下颌关节盘不可复性前移位可有效复位关节盘，改善患者颞下颌关节运动情况与功能，并可缓解疼痛。

关键词: 颞下颌关节, 关节盘不可复性前移位, 颞下颌关节盘锚固术, 耳屏小切口