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It should be emphasised that TMJ replacement for this patient group presents with many difficulties, both in terms of the anaesthetic challenges outlined above and potential surgical pitfalls. Approach to the joint is often through distorted anatomy. The risk of complications includes scar formation, facial nerve damage, gustatory sweating, and external auditory meatus perforations, and the most dreaded of note are perforation into the middle cranial fossa and severe bleeding from the medial infratemporal fossa. It remains to be seen what the long-term outcomes of joint prostheses will be and, as yet consensus is therefore lacking on the optimal timing of surgery. TMJ concepts prostheses utilise materials well proven in orthopaedic reconstruction of the knee and hip. Although life expectancy of these prostheses is unknown, studies have shown service life of 8 years  and 10 years  without evidence of untoward wear or failure. It is postulated that due to the TMJ being a non-load-bearing joint, these devices may have a minimum lifespan of 15 to 25 years; however, in patients with a lifetime chronic illness, it remains difficult to counsel them to early or late intervention in respect of any potential need for further joint replacement.
This work is an accurate synthesis of a major portion (=?50%) of the most productive medical misconceptions amongst the medical fraternity and health-care practitioners in the Middle East. But, the dismal state of affairs in the Middle East may have been responsible, for a large part, for this work being of very little use or significance in this part of the world. The present work may be of some use in the Middle East or any part of the world where medical misconceptions are quite rampant and may even prove to be a life-saving book for thousands of patients. It is evidently a well-researched work where even most of the very common mistakes and misconceptions have been carefully put in order. A thorough, good guide that all doctors, paramedics and paramedical staffs need to become very familiar with. It is certain that the present work will become a must-read thing. d2c66b5586