Contamination of the surgical site and/or displacement of the anesthetic naso- endotracheal tube (NET) during TMJ TJR can be avoided by suturing the NET to the nasal septum. The NET, as well as associated tubing and equipment, can then be directed caudally and away from the surgical field decreasing the potential for NET contamination of the sterile field and/or its displacement .
After the patient is anesthetized and the airway is secured, the eyes should be lubricated, taped shut, and protected to prevent corneal injury, conjunctivitis from blood/ irrigation, or contamination of the surgical field .
After shearing, not shaving, the hair to above the ear, the remaining hair should be drawn up toward the crown of the head, away from the planned incision sites. Foam tape can be used to wrap the head circumferentially (forehead-above the ear- occiput) so that the hair will be kept out of the surgical field .
Thorough irrigation of the auditory canal with a gentle bactericidal solution should be performed before skin preparation and final sterile draping. The external auditory canal should be occluded to prevent wound contamination during surgery from the egress of bacterial flora and/or accumulation of irrigation fluid and/or blood intraoperatively. A cotton pledget moistened with sterile mineral oil provides one among many occlusive options .