When ZACDs have been demonstrated preoperatively on a radiograph, these may become contraindication to performing surgical procedures such as eminoplasty or eminectomy for the treatment of mandibular dislocations as they can become potential pathways for intracranial infections.
Inadvertent violation of an air cell during eminectomy, producing communication with the infratemporal or middle cranial fossa poses the genuine danger of intracranial infection and/or hemorrhage.
Key words: Temporomandibular joint, disorders, conservative management, arthroscopy, arthrocentesis, surgical repositioning, dautery procedure, eminectomy
Surgical techniques used for the chronic dislocation includes partial or complete myotomy, capsular plication (Mayer, 1933) sacrification of the temporalis tendon (Mawan/McKean, 1973), open condylotomy (James, 1971), insertion of implants into the articular eminence (Findlay, 1964; Cardoso et al., 2005), down-fracturing of the zygomatic arches (Girard, 1943), augmentation of the eminence by allografts (Keith, 1988; Whear et al., 1991) and eminectomy (Myrhaug, 1951; Undt et al., 1997).