CPT® Code 29804

An arthroscopy of the temporomandibular joint (TMJ) is a minimally invasive surgical procedure that allows for both diagnosis and treatment of various structural disorders affecting the joint. The TMJ is a complex joint that connects the jawbone to the skull, and it can be affected by conditions such as disc displacement, fibrous adhesions, and other injuries or diseases. During the procedure, two specific entry points are identified based on anatomical landmarks: the posterior border of the tragus of the ear and the lateral canthus of the eye. This precise localization is crucial for accessing the joint effectively. A needle is first used to puncture the skin at the anterior entry point, allowing the surgeon to reach the zygomatic bone, which serves as a guide for further access into the superior joint space. Following this, a trocar within a cannula is inserted at the posterior entry point using an inferolateral approach directed toward the glenoid fossa, where the joint capsule is punctured. This technique enables the introduction of an arthroscope, which is a specialized instrument equipped with a camera, allowing for visualization of the TMJ. The procedure may include diagnostic elements, such as examining the joint for signs of injury or disease, and may also involve therapeutic interventions, such as the lysis of fibrous adhesions, which is a common treatment for persistent anterior disc displacement. The use of additional portals may facilitate the introduction of surgical instruments to enhance the treatment process. Ultimately, the arthroscope and any surgical tools are removed, and the incisions are closed, marking the completion of the procedure.