Introduction: The dislocation of the temporomandibular joint (TMJ) typically occurs when the mandibular condyle becomes displaced out of the glenoid fossa. Long-standing TMJ dislocation may rarely be treated by conventional methods of closed reduction, thus needing surgical intervention ranging from various indirect traction techniques to direct exposure of the TMJ.
Aim: This article aimed at bringing into attention of the scientific community a new surgical technique for the management of long-standing TMJ dislocation.
Materials and methods: A surgical technique of reducing longstanding TMJ dislocation dubbed as the “Shabani maneuver” has been described. The technique utilizes an externally applied force by physician/surgeon at the mandibular notch which is accessed through a preauricular incision. After making the incision, the mandibular notch is accessed and a Warwick- James elevator is then directed at the notch. An inferiorly directed force is applied once the instrument is secured around the notch and with a combination of conventional method, the condylar head is reduced back to the glenoid fossa.
Results: A total of 20 patients with long-standing TMJ dislocation were treated using the technique described. Out of those, 19 patients (95%) were successfully treated. The age range of the patient was between 19 and 81 years with a mean age of 37.75 ± 18.12 years. Yawning was the common cause for dislocation (65%). The mean duration of dislocation was 3.6 months, with the commonest reason for delay in treatment seeking being poverty.
Conclusion: This invasive surgical technique is useful where conventional approaches have been tried and proved futile in multiple attempts to reduce long-standing cases of TMJ dislocation.
Clinical significance: By describing a new and novel surgical technique for the reduction of long-standing TMJ dislocation, this study promotes its use in clinical practice, especially in settings of developing countries where due to low socioeconomic status, accessibility to operating theater is limited.
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