Repositioning of the Temporo-Mandibular Joint (TMJ) Disc
Within the TMJ there is a disc that is made of cartilage. The disc separates the socket (temporal bone) and the head of the lower jaw (mandible). The head of the jaw slides in the socket during the opening and closure of the mouth. The disc accommodates the movement of the jaw. Unfortunately, in some people, the disc slips forward resulting in a spatial change in the joint that may affect the opening and closure of the mouth. The opening and closure may produce clicks caused by sliding of the head over the disc. This can potentially cause pain when chewing, and limiting an individual’s ability to open the mouth wide enough to eat, brush teeth or to have a dental procedure.
Initial treatment is taking painkillers and the avoidance of heavy chewing. Physiotherapy, massage, stretching exercises, acupuncture, and the wearing of splints could be used to ease the pain associated with the mispositioned disc. In some patients, these treatments for painful clicking and locking TMJs are not successful and surgical treatment may be considered.
Following the examination in the doctor’s office, a patient needs to have an x-ray (Panorex) to rule out a trivial bone problem. However, the main method to assess the disc position is by MRI scan. If the scan confirms the disc displacement in a patient who has not had any relief from previous treatments, then the surgical repositioning of the disc can be contemplated.
The operation is done at Hospital under general anesthesia. While a patient is asleep, the hair patch in front of the ear is shaved. The incision is placed in the skin crease along the front of the ear. When the joint is opened the disc gets repositioned backward to its usual position and gets pinned to the bone with a special anchor.
After the surgery, the patient goes home. The drain from the TMJ area is removed on the next day and stitches are removed in one week.
During the first week, the diet is non-chewing, such as liquid foods. Then a soft diet is recommended for 5 weeks.
6 weeks after the surgery, the patient may start eating normal foods and stretching the mouth.
Side effects of the operation include numbness of the ear lasting 3-6 months. In very rare situations the eyebrow and a corner of the mouth can be temporarily weak.
80-94% of patients report improvement in pain and mouth opening.
Testimonials
I had my nose broken in school and I had a bump and needed my septum repaired. Being a 16 year old girl your face is pretty important. I was sent to Dr. Filatov and I am so grateful to have had him as a doctor. Not only was the staff amazing, but he made me feel so comfortable and he explained the whole surgery to me during the appointment and right before the surgery. He answered all of the questions that my parents and I had. He took great care of me before and after the surgery, great bedside manor. I not only can breathe through my nose again, but i have no visible scarring and I feel a lot better about myself. I highly suggest him as a doctor, especially a plastic surgeon. Thank you so much Dr. Filatov.
~R.S.
My family doctor referred me to Dr.Filatov as I was unable to close my right eye. I had a gold plate eyelid implant done. Each time i have been to see him it has been great, and the receptionist has been awesome. Dr.Filatov has a very good bedside manner, and I highly recommend him for anyone who needs surgery. He took great care and explained what had to be done. I am going back for a check up this week and will certainly go back to him if I need anything else done. For a specialist in particular I had a good experience.
~J.W.
I recently had blepharoplasty surgery and my family doctor recommended Dr. Filatov. I received excellent care from Dr. Filatov and his staff. Dr. Filatov took the time to explain the procedure, showing me videos and answering all my questions both before and after the surgery. I am extremely pleased wit the results and would recommend Dr. Filatov to anyone who is considering this surgery.
~S.D.
Dr. Filatov provided me with everything I hoped for and more. I had an accident in 2005 and broke the right side of my face. This left me with a titanium eye plate, a titanium cheek and a fractured jaw in three places. After suffering for years with a loss of confidence about me scarring for years, and after enduring excruciating pain in my eye and cheek which often left me debilitated with massive headaches, who knew a simple procedure could eliminate so many of my concerns. My scarring is unnoticeable except upon a close inspection. And even better, my headaches have virtually disappeared! Thank you so much, Dr. Filatov. And I would be amiss to overlook his excellent assistant Julie, who warmly guided me along from my first enquiry to the post surgery follow-up. I highly recommend Dr. Filatov for his expertise.
~M.J.
I was referred to dr filatov due to many years of sinus problems. I had ablarge hump and major deviation to the left. My nose was very crooked and it impaired my breathing, taste, and smell. I found dr filatov to be very professional, straight forward, and at times blunt. However, i appreciate honesty and forwardness from a surgeon. Dr filatov took the time to ask me many questions and i found him to be meticulous in his examinations. I need to be able to trust a surgeon, especially when operating on something so noticable (being self conscious to start). After a lot of research into cost, skill, education, knowledge, and results dr filatov's extensive education made me feel confident in his abilities (even when bedside manner is lacking). We are all human beings with good and bad days. I did not encounter bad bedside manner, his forwardness and blunt answers were anticipated most surgeons have people skills lacking...thats what you get when you have your nose in the books becoming a dr. His staff are empathetic, helpful, and easy to approach. I was terrified before surgery, so very happy i went for it. 2 weeks post op and i look amazing. Better than i anticipated. I was told by the nurse he took over 3 hours in the operating room with me. He anticipated an hour to hour and a half. That tells me he went above and beyond to ensure the reults were the best possible. What other surgeon operates out of the kindness of their heart? Thank you dr filatov for giving me confidence that i did not have before!
In December 2012 Dr. Filatov changed my life for the good :) I had many ugly scars on my face and he just started doing laser treatments in his office, so he offered to do my face at NO COST. Not many surgeons out there will offer free service like that, but he did! He to HIS time and costs of this laser machine to help ME! He really truly is a kind hearted gentleman, and knowledgeable in the procedures and consults he does. I had two treatments done on my face and even though the scars are not totally gone there is a remarkable difference for the better. He made me feel very comfortable, and even took my email when he went away on holidays to make sure I was healing properly. He also called my home over the holidays to check in with me as well, now tell me is that a man that doesn't care about his patients? He is our ONLY ENT in Prince George and it can be very overwhelming as he has a family and a life as well.
~K.C.
I recently had eyelid reduction surgery with a brow lift. Dr. Filatov was very informative, took the time to explain the surgery and the desired out come. He was courteous and punctual. His staff was awesome! All my questions were answered with out unrealistic expectations. My surgery went well and he checked in on me about a half hour after the surgery to make sure he had the desired result. I can't believe the difference in my eyes! They look fantastic! I know many people who have had different types of surgery all concerning cranial and facial areas, I have not found who has not said he has done a excellent job on their surgeries! I highly recommend Dr. Filatov to anybody I know needing cosmetic or ENT surgeries. If I ever need any further surgery in the future I will definitely be seeing Dr.Filatov. My results from my surgery were awesome! Thanks again Dr. Filatov.
~L.M.
Very informed and forthcoming. His dedication an thoroughness are always apparent, a doctor who does not rest on his laurels. I have visited Dr. Filatov on three occasions and have always had a total confidence in his diagnostic protocols and medical procedure. Given the flow-through of patients is very high in any specialist's practice, Dr Filatov is cautious and thorough, never rushing me out the door. Wish this fellow could give lessons to various & numerous GP's about bedside manner, they would do well to follow his example.
~B.V.
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