By Peter D. Quinn DMD MD
Univ. of Pennsylvania, Philadelphia. Surgical atlas meant to lead the amateur and skilled medical professional during the intraand extra-articular techniques which have been confirmed potent within the remedy of complex craniomandibular disorder. complete colour photographs. 2 U.S. individuals.
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Internal maxillary artery, retromandibular vein) • Avoid damage to the parotid gland • Maximize use of natural skin creases for cosmetic wound closure APPLIED ANATOMY Facial Nerve T h e main trunk of the facial nerve exits from the skull at the stylomastoid foramen. The suture line between the tympanic and mastoid portions of the mastoid bone is a reliable anatomic landmark because the main trunk of the facial nerve lies 6 to 8 mm inferior and anterior to this tympanomastoid suture. 3 cm of the facial nerve is visible until it divides into temporofacial and cervicofacial branches.
Once the joint surgery is completed, a resorbable 4-0 running suture is used to close the skin of the ear canal only. No attempt is made to suture the cartilage itself. FIG. Postauricular approach to temporomandibular joint. 17 Color Atlas of Temporomandibular joint Surgery 42 FIGS. 19 Postauricular approach lo temporomandibular joint. The incision has Relative position of the superficial temporal artery and veil and the been made through skin and subcutaneous tissue. The external audi- temporal branch of the facial nerve.
Care must be taken when entering the superior or inferior joint space so as not to cause iatrogenic injury to the disk, which could cause a reparable disk to become irreparable. A B A, MRI showing separate and distinct heads of lateral pterygoid with fat plane separation. B, Cryoseclion depicting clear separation of lateral pterygoid heads showing inferior belly extending through anterior wall of capsule directly into fovea of the condyle. 60 Color Atlas of Temporomandibular Joint Surgery position the disk posteriorly and laterally.