Efficacy of Deep Subfascial Approach to the Temporomandibular Joint

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The aim of this study was to report the efficacy of the deep subfascial approach for the treatment of temporomandibular joint pathologies. The procedure set out below satisfies a wide-access approach for the prevention of facial nerve injury.

Materials and Methods

The preauricular approach with the additional deep subfascial approach was applied to 18 patients who had various problems from ankylosis to internal derangement. All patients were assessed at the following postoperative times. Facial nerve functions were evaluated after surgery and 24 hours after surgery by the House-Brackmann facial nerve grading system.


Temporary facial nerve palsy was seen in a patient who had a residual keratocyst in the condylar neck region. Other patients tolerated the procedure well, and there were no other complications.


This procedure significantly decreased the risk of facial nerve injury. However, soft tissue traction at the condylar neck region or zygomatic arch where the facial nerve passes close by may increase the risk of nerve damage.

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