Disk reposition procedure

Question 1

indication for dice reposition procedure

Answer 1

failure of conservative therapy, wilkes 2-5

Question 2

where is incision made for disk reposition procedure?
what can you do to increase access?

Answer 2

pre-auricular crease
al-Kayat extension

Question 3

incision for disk reposition procedure, what are the layers?

Answer 3

-skin
-subQ
-temporoparietal fascia
-auricularis anterior muscle
-temporalis fascia layer - use nerve monitor
-palpate zygomatic arch
-incise periosteum
-dissect subperiosteum until joint capsule
-insufflate joint w/ local anesthesia or saline
-incision into joint capsule to enter superior joint space
-mobilize disk, assess for perforations

Question 4

what do you do if perforations in disk?

Answer 4

-if small- repair
-if large perforation remove disk

Question 5

How to plicate disk in posteriolateral vector to the disk capsule or temporalis fascia by

Answer 5

-non-resorbable suture
-Mitek anchor

Question 6

how to recognized temporalis fascia?

Answer 6

glistening white color, not as thick as in galea

Question 7

what runs in the temporoparietal fascia?

Answer 7

temporal branch of the facial nerve from 8-35 mm from the bony anterior extent of the external auditory meatus.