Luke has expertise in all degrees of TMJ surgery and when it is necessary provides highly skilled open jaw procedures including eminectomy and arthroplasty.
What is open jaw joint (TMJ) surgery?
Broadly speaking open surgery can be divided into:
- Disc reduction and fixation (discopexy / meniscoplasty)
- Disc removal and grafting (meniscetomy / discectomy)
- Resection of tumour or diseased tissue with or without reconstruction or grafting such as osteochondroma
The jaw joint has a tiny disc that moves as the jaw moves up and down. This is known as the meniscus. If the disc/meniscus is displaced but not too badly damaged, Luke can put it back in its proper place and fix it there with tiny sutures.
This involves a day case operation under general anaesthetic, and you will need an incision in front of the ear.
This is a similar procedure to a meniscoplasty but is done if your disc is too damaged to be repaired. In a meniscetomy, Luke will remove the disc completely. He usually reconstructs the joint with a fat graft from your abdomen.
How is open jaw joint (TMJ) surgery performed?
Open joint surgery is carried out under general anaesthesia with a tube going into your nose. The surgery takes around an hour and sometimes requires overnight stay and a week or so off work afterwards.
Luke will usually provide you with an OraStretch device to enable you to carry out post-operative physiotherapy yourself at home afterwards and he will see you approximately a week later.
What are the risks of the procedure?
The main risks are infection, bleeding, scarring, facial weakness and numbness and pain.
Infection is very rare as is troublesome bleeding. Facial nerve weakness is also rare, although it is not uncommon to have some weakness after the surgery for a day or so due to the local anaesthetic used, however permanent weakness of the brow or eye muscles is very rare, less than 1%.
It is normal for the area over the joint to remain numb after surgery as there is a small nerve within the joint which is inevitably removed during open jaw joint TMJ surgery, however this is not usually noticed after a while and the area of numbness is actually quite small.
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I was under Mr Cascarini’s care for a number of years with TMJD. Throughout the duration of my treatment, the level of care I received as well as the kind and knowledgeable approach from him and his colleagues was flawless. I was made aware of what was happening at all…
Luke Cascarini is by far the most committed, knowledgeable, caring and patient oriented down to earth consultant I’ve ever met so far. Unfortunately due to other health issues I regularly see a lot of other consultants privately but there is no comparison! I felt like there was finally somebody who…