Хирургические методы лечения перфорации диска височно-нижнечелюстного сустава: Современные подходы и перспективы на будущее
DOI:
https://doi.org/10.70439/2075-8790.2025.98.4.010Ключевые слова:
височно-нижнечелюстной сустав, перфорация диска, артроскопическая хирургия, открытая хирургия сустава, регенеративная терапияАннотация
Перфорация диска височно-нижнечелюстного сустава (ВНЧС) — конечная стадия внутреннего повреждения, которая вызывает боль, дисфункцию и остеоартритные изменения. В данном обзоре кратко рассматриваются этиология, патофизиология, диагностика и лечение. Хроническая механическая перегрузка и воспаление разрушают матрикс диска, приводя к перфорации. Хотя МРТ может указывать на перфорацию, артроскопия остается окончательным диагностическим инструментом. После курса консервативной терапии небольшие или умеренные перфорации могут быть устранены артроскопически (лизис/промывание, санация краев или дископексия), при этом исследования сообщают о значительном облегчении боли и улучшении открывания рта. Более крупные или дегенеративные разрывы часто требуют открытой хирургии (восстановление диска, дискэктомия, интерпозиционные трансплантаты или замена сустава). Новые методы тканевой инженерии (к примеру, каркасы с засеянными стволовыми клетками) демонстрируют перспективность при регенерации невосстановимых дисков. В будущих исследованиях следует отдавать приоритет рандомизированным испытаниям, стандартизированным результатам и биологическим методам лечения для оптимизации долгосрочной функции ВНЧС.
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