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The diagnostic accuracy of temporomandibular joint arthroscopy was evaluated at autopsy. Arthroscopy was performed in the upper compartment of 36 temporomandibular joints in 18 fresh cadavers to investigate the accuracy of arthroscopic diagnosis of disc perforation and two types of adhesion (band adhesion and pseudowall).Punctures were made by inferolateral, anterolateral, and endaural approaches. Subsequent dissection revealed that eight of nine disc perforations had been accurately diagnosed arthroscopically and that all band adhesions had been diagnosed arthroscopically. Six of seven pseudowalls had been diagnosed, but four pseudowalls had been overdiagnosed arthroscopically.Therefore, the diagnostic accuracy of disc perforation was 97%, that of band adhesion was 100%, and that of pseudowall was 86%. It was concluded that arthroscopic diagnosis of disc perforation or band adhesion was reliable, whereas arthroscopic diagnosis of pseudowall was not reliable. Double-puncture penetrating from two different directions, either an inferolateral-anterolateral approach or an inferolateral-endaural approach, was considered to be significantly more effective for diagnosing disc perforation within the lateral third of the joint.

Postmortem study on diagnostic accuracy of temporomandibular joint arthroscopy: pathologic findings in the superior joint compartment.