Arthroscopic anatomy of the equine temporomandibular joint.
Authors: May K A, Moll H D, Howard R D, Pleasant R S, Gregg J M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Arthroscopic Anatomy of the Equine Temporomandibular Joint May et al. (2001) established the first systematic arthroscopic approach to the equine temporomandibular joint (TMJ), addressing a significant gap in diagnostic capability for this notoriously difficult-to-access structure. Using ten cadaveric heads and five live horses, the researchers developed and validated a caudodorsal arthroscopic portal that provided optimal visualisation of the dorsal compartment, including the rostral and caudal synovial pouches, articular disc, and lateral joint structures. Whilst this approach proved reliable, examination of the medial compartment remained limited to rostral and caudal margins, and the ventral compartment was inaccessible due to the transverse facial vasculature—a significant anatomical constraint for practitioners. In the five live horses, the procedure proved well-tolerated with only mild, self-limiting fluid extravasation and periarticular swelling resolving within 48 hours, despite minor iatrogenic damage to articular fibrocartilage and the parotid gland observed in cadaveric dissection. For equine practitioners managing suspected TMJ pathology, particularly conditions affecting the lateral and caudal dorsal aspects, this technique offers a validated diagnostic and potentially therapeutic option, though a comprehensive understanding of its limitations—particularly regarding ventral compartment access—remains essential for appropriate case selection and realistic expectation-setting with horse owners.
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Practical Takeaways
- •Caudodorsal approach is the technique of choice for TMJ arthroscopy in horses and allows adequate visualization of lateral and caudal dorsal compartment lesions
- •Ventral compartment pathology cannot be visualized arthroscopically due to vital vascular anatomy; alternative diagnostic or therapeutic approaches may be needed for ventral lesions
- •Procedure is well-tolerated with minimal complications and rapid recovery; horses resume normal function quickly post-operatively
Key Findings
- •Caudodorsal arthroscopic approach provided optimal visualization of the dorsal TMJ compartment including rostral and caudal synovial pouches and lateral articular disc
- •Medial joint examination was limited to rostral and caudal aspects only
- •Access to ventral compartment was precluded by transverse facial artery and vein location
- •Minimal iatrogenic damage occurred (fibrocartilage, disc, parotid gland penetration) with no adverse clinical effects; all horses ate normally post-operatively with mild swelling resolving within 2 days