Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • 제34권6호
  • /
  • Pages.644-648
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  • 2008
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  • 2234-7550(pISSN)
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  • 2234-5930(eISSN)
대한구강악안면외과학회 (The Korean Association of Oral and Maxillofacial Surgeons)
권호 표지

하악 과두하 골절시 구강내 접근의 문헌 고찰과 임상 연구

THE LITERACTURE REVIEW AND CLINICAL EVALUATION OF INTRAORAL APPROACH FOR SUBCONDYLAR FRACTURE

  • 서현수 (한림대학교 의과대학 구강악안면외과학교실) ;
  • 홍순민 (한림대학교 의과대학 구강악안면외과학교실) ;
  • 유승은 (한림대학교 의과대학 구강악안면외과학교실) ;
  • 박준우 (한림대학교 의과대학 구강악안면외과학교실)
  • Seo, Hyun-Soo (Department of Oral & Maxillofacial Surgery, Kang-dong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Hong, Soon-Min (Department of Oral & Maxillofacial Surgery, Kang-dong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Yoo, Seung-Eun (Department of Oral & Maxillofacial Surgery, Kang-dong Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Park, Jun-Woo (Department of Oral & Maxillofacial Surgery, Kang-dong Sacred Heart Hospital, College of Medicine, Hallym University)
  • 발행 : 2008.12.31
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초록

Purpose: The aim of this study was to investigate the clinical cases of subcondylar fracture with intraoral approach. Material and Method: Fifteen patients with unilateral subcondylar fracture were treated in the department of oral and maxillofacial surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University between 2006 and 2007. Each patients was examined by computed tomography(CT) and panorama. 3D-CT taken when fractured segment was displaced and comminuted. Patients was done intermaxillary fixation to occlusal stability and prevent displacement of fractured segment before general operation. Open reduction and internal fixation(ORIF) accomplished under general anesthesia and used to intraoral approach. We examinated the state of occlusion, maximum opening. Evaluation of the state of occlusion was divided in patient`s subjective evaluation that compare pre-traumatic occlusion with postoperative occlusion, and estimator`s objective evaluation that use articulating paper. Examination was done at 2 weeks, 1, 3, 6 month postoperative by follow up. Result: The ORIF through intraoral approach was good in all patients. In the state of occlusion, all patients recovered pre-traumatic occlusion in 6 month postoperation. Maximum opening was gradually increased. In 3 month postoperative, maximum opening was excessed 40mm. Conclusion: Our study indicate that the intraoral approach is a good technique for subcondylar fracture. Intraoral approach prevent complication that facial nerve damage, scar formation caused by extraoral approach. So, we recommend intraoral approach when subcondylar fracture.

키워드

참고문헌

  1. 이슬기 송, 김좌영, 송상훈, 양병은, 최원철, 김성곤. 하악골 과두하 골절 시 후하악접근법 통해 ORIF 시행한 환자들의 술 후 추적조사. 대한구강악안면외과학회지 2007;33(6):631-35
  2. 이상철 김, 류동목, 이백수, 윤옥병, 진택현. 하악 과두 골절의 임상통계학적 연구. 대한구강악안면외과학회지 1998;24:326-29
  3. L L. Condylar fractures of the mandible. I. Classification and relation to age, occlusion, and concomitant injuries of teeth and teethsupporting structures, and fractures of the mandibular body. Int J Oral Surg 1977;6:12-21 https://doi.org/10.1016/S0300-9785(77)80067-7
  4. Silvennoinen U LT, Linqvist C, Oilarinen K. Difference patterns of condylar fractures: an analysis of 382 patients in a 3 year period. J Oral Maxillofac Surg. 1992;50:1032-37 https://doi.org/10.1016/0278-2391(92)90484-H
  5. McArthur C DP, Knowles J, Moore C. Open reduction fixation of mandibular subcondylar fractures. Arch Otolaryngol Head Neck Surg 1993;119:403-6 https://doi.org/10.1001/archotol.1993.01880160049008
  6. Edward Ellis III MFZ. 안면골에 대한 외과적 접근법. 서울 상아출판사 2001
  7. al Ce. Short retromandibular approach of subcondylar fractures. Oral Surg Oral Med Oral Patho Oral Radio Endod 1996;82:248-52 https://doi.org/10.1016/S1079-2104(96)80347-7
  8. Zide MF KJ. Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg 1983;41:89 https://doi.org/10.1016/0278-2391(83)90214-8
  9. Ellis E MD, Simon P, et al. Surgical complications with open treatment of mandibular condylar process fractures. J Oral Maxillofac Surg 2000;58:950 https://doi.org/10.1053/joms.2000.8734
  10. Choi BH YJ. Open reduction of condylar neck fractures with exposure of the facial nerve. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:292 https://doi.org/10.1016/S1079-2104(99)70030-2
  11. L L. Condylar fractures of the mandible: I classification and relation to age, occlusion, and concomitant injuries of teeth and teeth supporting structures, and fractures of the mandibular body. Int J Oral Surg 1997;6:12 https://doi.org/10.1016/S0300-9785(77)80067-7
  12. Ellis E PC, Throckmorton G. Further displacement of condylar process fractures after closed treatment. J Oral Maxillofac Surg 1999;57:1307 https://doi.org/10.1016/S0278-2391(99)90867-4
  13. Jensen T JJ, Norholt SE, Dahl M, Lenk-Hansen L, Svensson P. . Open reduction and rigid internal fixation of mandibular condylar fractures by an intraoral approach: a long-term follow-up study of 15 patients. J Oral Maxillofac Surg. 2006;64(12):1771-9 https://doi.org/10.1016/j.joms.2005.12.069
  14. Eills E RS, Park HS. A method to rigidly fix high condylar fractures. Oral Surg Oral Med Oral Patho 1989;68:369-74
  15. Okesen. Management of Temporomandibular Disorders and Occlusion. Mosby 1999
  16. Ellis E DJ. Rigid fixation of mandibular condyle fractures. Oral Surg Oral Med Oral Patho 1993;76:6-15 https://doi.org/10.1016/0030-4220(93)90285-C
  17. M. Manisali MA, B. Aghabeigi, L. Newman. Retromandibular approach to the mandibular condyle : a clinical and cadaveric study. Int. J. Oral maxillofac Surg 2003;32:253-56 https://doi.org/10.1054/ijom.2002.0270
  18. Jensen T JJ, Norholt SE, Dahl M, Lenk-Hansen L, Svensson P. . Open reduction and rigid internal fixation of mandibular condylar fractures by an intraoral approach: a long-term follow-up study of 15 patients. J Oral Maxillofac Surg. 2006;64(12):1771-9 https://doi.org/10.1016/j.joms.2005.12.069
  19. Richard A Loukota PJM. Condylar neck fracture. Peter WB. Barry LE. Rainer S. Maxillofacial trauma and Esthetic facial reconstruction 1st ed. Philadelphia, Churchill Living stone 2003:281-90
  20. Tasanen A LM. Transosseous wiring in the treatment of condylar fractures of the mandible. J Oral Maxillofac Surg 1976;4:200-11
  21. LinksJensen T JJ, Norholt SE, Dahl M, Lenk-Hansen L, Svensson P. Open reduction and rigid internal fixation of mandibular condylar fractures by an intraoral approach: a longterm follow-up study of 15 patients. J Oral Maxillofac Surg. 2006;64(12):1771-9 https://doi.org/10.1016/j.joms.2005.12.069
  22. JL1 W. Rowe and Williams'Maxillofacial Injuries. 2nd Ed. Churchill Livingstone 1994:409
  23. C.A Landes RL. Prospective evaluation of a pragmatic treatment rationale: open reduction and internal fixation of didplaced and dislocated condyle and condylar head fractures and closed reduction of non-displaced, non-dislocated fractures. Int J Oral Maxiilofac Surg 2005;34:859-70 https://doi.org/10.1016/j.ijom.2005.04.021
  24. Hammer B SP, Prein J. Osteosynthesis of condylar neck fractures: A review of 30 patients. Br J Oral Maxillofacial Surg 1997;35:288 https://doi.org/10.1016/S0266-4356(97)90050-4
  25. Haug RH PG, Goltz M. A biomechanical evaluation of mandibular condyle fracture plating techniques. J Oral Maxillofac Surg 2002;60:73 https://doi.org/10.1053/joms.2002.29078