Abstract: PURPOSE: To introduce a modified surgical approach for treating temporomandibular joint (TMJ) disc displacement using tragus incision with vascular-guided multilayer approach and evaluate its clinical outcome. METHODS: Six patients (7 joints) were selected in this study. All patients were diagnosed as stage IV-V of TMJ internal derangement according to Wilkes-Bronstein staging system. All patients underwent open surgery for TMJ disc repositioning and fixation using the modified tragus incision with vascular-guided multilayer approach. TMJ MRI was performed 4 days postoperatively. RESULTS: Good surgical field exposure was obtained and TMJ disc were well replaced in all operations. Postoperative MRI showed satisfactory position of the TMJ disc. The function of facial nerve was well preserved in all patients. CONCLUSIONS: The modified tragus incision with vascular-guided multilayer approach is one of the ideal methods for TMJ open surgery to treat anterior disc displacement.

Key words: Temporomandibular joint, Tragus incision, Surgical approach