Patients with a painful clicking jaw could be spared major surgery thanks to a new ‘pinhole’ procedure that cures the condition with a single invisible stitch.
The £5,000 operation can be carried out as a day case and leaves no scars. Patients who may have suffered years of distressing discomfort are left pain-free within days.
Problems with the temporomandibular joints – the two areas that join the jaw to the rest of the skull – affect at least a third of all adults at some stage.
It can be due to muscle damage or, more commonly, because tiny discs of cartilage that sit within the joint slip out of place or deteriorate.
Cartilage is a tough, silky substance and the discs act as cushions, allowing smooth movement of the jaw.
Patients with a painful clicking jaw could be spared major surgery thanks to a new ‘pinhole’ procedure that cures the condition with a single invisible stitch. The £5,000 operation can be carried out as a day case and leaves no scars
If for some reason they move into the wrong position, the jaw can become locked. Symptoms include pain and a clicking or popping feeling when the jaw is used – while eating, for instance.
People who are double-jointed or who grind their teeth unconsciously – a condition known as bruxism – are more likely to be affected.
For most, symptoms will clear up on their own. Simple jaw exercises also help, while some people may use a mouthguard that gently moves the jaw into place at night.
However, some patients endure relentless pain and discomfort. A procedure, during which the joint is flushed out with fluid, helps in up to 80 per cent of cases.
But for the remainder, open surgery to reposition the cartilage has previously been the only option.
Recovery from this can be uncomfortable and patients are left with a visible scar along the jawline.
The new 20-minute procedure, developed in the United States and now being offered privately in the UK, is carried out through needle incisions of just a few millimetres in the front of the ear.
‘It is minimally invasive, which not only means no scarring and a quicker, less painful recovery, but we are also reducing the risk of complications by avoiding having to cut near vital nerves in the jaw,’ explains Luke Cascarini, consultant head and neck surgeon at Guy’s and St Thomas’ NHS Foundation Trust in London.
Problems with the temporomandibular joints – the two areas that join the jaw to the rest of the skull – affect at least a third of all adults at some stage. It can be due to muscle damage or, more commonly, because tiny discs of cartilage that sit within the joint slip out of place or deteriorate. (File photo)
The operation is carried out under a general anaesthetic. Three fine hollow needles – known as trocars – are inserted around the jaw, through which a fibre-optic camera and instruments can be inserted.
The joint is filled with fluid via one of the trocars to expand the space inside it, which allows the instruments more room to move.
Once the camera is in place, real-time images within the joint are shown on a screen. ‘It is the smallest joint operation of its kind possible,’ explains Mr Cascarini.
A special instrument is used to pass the stitch through the cartilage disc and move it into the correct position.
The stitch is then pulled back out of the joint and secured in place just beneath the skin, below the earlobe.
Patients are typically allowed home the same day.
‘We tell them not to eat solid food for three weeks,’ adds Mr Cascarini, who began carrying out the new procedure last year.
‘This is so as not to load the jaw while the joint is healing. But patients don’t report much pain during this time. We also advise they use a Therabite, a device that helps exercise the jaw and build up the muscles around it.’
Ellie Jade-Smith, 24, from Benfleet, Essex, developed a clicking jaw after it was injured in an accident in 2016. She says: ‘I was given painkillers and even Botox injections, but I was still in agony all the time.’
Ellie, a student at Anglia Ruskin University, was referred to Mr Cascarini earlier this year, and underwent her operation in June.
‘Three hours after surgery, I was on my way home,’ she says. ‘There is still some tenderness but nothing like the pain I had before, and there has been no clicking of my jaw, which is a huge relief.’
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