Modern temporomandibular joint arthroscopy: Operative single-cannula arthroscopy

Since the introduction of arthroscopy, the management of temporomandibular joint (TMJ) disorders has improved significantly. The arthroscope facilitates both assessment of the joint and its pathologies as well as visualized surgical interventions. The traditional arthroscopy technique requires the creation of one puncture for diagnosis and two punctures to enable visualization and operation. The alternative operative single-cannula arthroscopy (OSCA) technique presented here is an advanced TMJ arthroscopy technique which requires only a single cannula, through which a single- piece instrument containing a visualization canal, irrigation canal, and a working canal is inserted. OSCA empowers performance of "one-track arthrocentesis" and standard arthrocentesis under diagnostic visualization and supports introduction of hand or mechanical instruments or laser (holmium:YAG) to perform visually guided surgery. The technique has proven as efficient as the traditional technique, with the added benefits of a short learning curve and simplicity of execution. This chapter provides a detailed protocol for the management of TMD using the OSCA technique.