Imaging
Diagnosing, classifying and planning treatment for surgical pathology has, and always will, rely on imaging.
“Seeing” the problem is essential for a surgeon. Imaging modalities continue to become more elegant as technology advances. In all areas of medicine, disease is classified then treated based on the classification. For example, a vascular surgeon will assess the amount of carotid stenosis based on imaging of structure and flow of blood. This information is classified and used in conjunction with the entirety of a patient’s presentation to guide the surgeon’s treatment.
Dr. Shah approaches TM joint pathology in the same way. A cone beam CT scan (CBCT) is utilized to evaluate the bony anatomy of the TM joints, maxillofacial skeleton and the volume of the nasopharyngeal airway. This data can elucidate diagnoses such as degenerative TM joint arthritis, maxillofacial growth abnormalities, nasal septal deviations and constricted airway volumes. Without “seeing” these abnormalities they cannot possibly be treated correctly.
Often, an MRI is required to evaluate the internal structure of the TM joints. Specifically, the articular discs can be evaluated as well as the condylar marrow signal and the soft tissue fluid status. Dr. Shah utilizes a specific imaging sequence to obtain the most relevant data for classification and ultimately treatment.
NOT EVERYONE NEEDS IMAGING. Based on basic medical teaching, further testing is only required if indicated by history and physical exam.