Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지

Retromandibular Approach for the Open Reduction of Fractured Mnadibular Condyle

하악과두 골절의 관혈적 정복술을 위한 하악 후방 접근법

  • Kim, Hak-Kyun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Chosun University) ;
  • Kim, Su-Gwan (Department of Oral and Maxillofacial Surgery, College of Dentistry, Chosun University) ;
  • Kang, Dong-Wan (Department of Prosthodontics, College of Dentistry, Chosun University) ;
  • Oh, Sang-Ho (Department of Prosthodontics, College of Dentistry, Chosun University)
  • 김학균 (조선대학교 치과대학 구강악안면외과학교실) ;
  • 김수관 (조선대학교 치과대학 구강악안면외과학교실) ;
  • 강동완 (조선대학교 치과대학 보철학교실) ;
  • 오상호 (조선대학교 치과대학 보철학교실)
  • Published : 2006.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

There are several manners for surgical approaches to the mandibular condyle. With the retromandiular approach, the condyle and fracture are exposed directly and allow for good inspection and reduction. The retromandibular scar is very well camouflaged and practically invisible. The aim of this study was to evaluate clinical results of retromandibular approach for the reduction and fixation of fractured mandibular condyles. We described postoperative complications such as temporary facial nerve weakness involving the marginal mandibular branch, mouth opening limitation and malocclusion in 13 patients with mandubular condylar fractures; 11 subcondylar fractures and 2 condylar neck fractures. The follow-up period was longer than 6 months in all patients. The retromandibular approach was successful in all subcondylar fracture cases. 2 patients with condylar neck fracture had mouth opening limitation and temporary marginal nerve palsy longer than 3 months. But there were no cases of permanent nerve injury and malocclusion. Our findings indicate that retromandibular approach is an easy and safe technique for subcondylar fracture but not for condylar neck fracture.

Keywords

Acknowledgement

Supported by : 조선대학교

References

  1. Manisali M, Amin M, Aghabeigi B, Newman L. Retromandibular approach to the mandibular condyle: a clinical and cadaveric study. Int J Oral Maxillofac Surg 2003;32: 253-256 https://doi.org/10.1054/ijom.2002.0270
  2. Zide MF, Kent JN. Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg 1983;41: 89-98 https://doi.org/10.1016/0278-2391(83)90214-8
  3. Lindahl L, Hollender L. Condylar fractures of the mandible. II. A radiographic study of remodeling precesses of temporomandibular joint. Int J Oral Surg 1977;6: 153-65 https://doi.org/10.1016/S0300-9785(77)80048-3
  4. Lindahl L. Condylar fractures of the mandible. IV. Function of the masticatory system. Int J Oral Surg 1977:6: 195-203 https://doi.org/10.1016/S0300-9785(77)80009-4
  5. Widmark G, Bagenholm T, Kahnberg KE, Lindahl L. Open reduction of subcondylar fractures. A study of functional rehabilitation. Int J Oral Maxillofac Surg 1996;25: 107-111 https://doi.org/10.1016/S0901-5027(96)80052-X
  6. Baker A W, McMahon J, Moos KF. Current consensus on the management of fractures of the mandibular condyle. A method by questionnaire. Int J Oral Maxillofac Surg 1998;27: 258-266 https://doi.org/10.1016/S0901-5027(05)80507-7
  7. Vesnaver A, Gorjanc M, Eberlinc A, Dovsak DA, Kansky AA. The preauricular transparotid approach for open reduction and internal fixation of condylar fractures. J Craniomaxillofac Surg 2005;33: 169-179 https://doi.org/10.1016/j.jcms.2005.01.008
  8. Ellis EE, Zide MF. Retromandibular Approach. In: Ellis EE, Zide MF (Eds.), Surgical Approaches to the Facial Skeleton. Baltimore: Williams & Wilkins; 1995:154-160
  9. Chossegros C, Cheynet F, Blanc J, Bourezak Z. Short retromandibular approach to subcondylar fractures. Clinical and radiologic long-term evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82: 248-252 https://doi.org/10.1016/S1079-2104(96)80347-7
  10. Devlin MF, Hislop WS, Carton ATM. Open reduction and internal fixation of fractured mandibular condyles by a retromandibular approach: surgical morbidity and informed consent. Br J Oral Maxillofac Surg 2002;40: 23-25 https://doi.org/10.1054/bjom.2001.0748
  11. Lachner J, Clanton JT, Waite PD. Open reduction and internal rigid fixation of subcondylar fractures via an intraoral approach. Oral Surg Oral Med Oral Pathol 1991:71; 257-261 https://doi.org/10.1016/0030-4220(91)90295-N
  12. Lee C, Mueller RV, Lee K, Mathes SJ. Endoscopic subcondylar repair: functional, aesthetic, and radiographic outcomes. Plast Reconstr Surg 1998:102; 1434-1445 https://doi.org/10.1097/00006534-199810000-00016
  13. Miloro M. Endoscopic-assisted repair of subcondylar fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96: 387-391 https://doi.org/10.1016/j.tripleo.2003.07.004
  14. Ellis EE, Dean J. Rigid fixation of mandibular condyle fractures. Oral Surg Oral Med Oral Pathol 1993;76: 6-15 https://doi.org/10.1016/0030-4220(93)90285-C
  15. Worsaae N, Thorn J. Surgical versus nonsurgical treatment of unilateral fractured and dislocated low subcondylar fractures. A clinical study of 52 cases. J Oral Maxillofac Surg 1994;52: 353-60 https://doi.org/10.1016/0278-2391(94)90436-7
  16. Villarreal PO, Monje F, Junquera LM, Mateo J, Morillo AJ. Gonzalez C. Mandibular condyle fractures: determinants of treatment and outcome. J Oral Maxillofac Surg 2004;62: 155-163 https://doi.org/10.1016/j.joms.2003.08.010
  17. Hinds EC, Girotti WJ. Vertical subcondylar osteotomy: a reappraisal. Oral Surg Oral Med Oral Pathol 1967;24: 164-170 https://doi.org/10.1016/0030-4220(67)90256-3
  18. Loukota RA, Eckelt U, De Bont L, Rasse M. Subclassification of fractures of the condylar process of the mandible. Br J Oral Maxillofac Surg 2005:43; 72-73 https://doi.org/10.1016/j.bjoms.2004.08.018