• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.356-360
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• 2017

The tympanic plate is a small part of the temporal bone that separates the mandibular condyle from the external auditory canal. Fracture of this small plate is rare and usually associated with other bony fractures, mainly temporal and mandibular bone. There is a limited amount of literature on this subject, which increases the chance of cases being overlooked by physicians and radiologists. This is further supported by purely isolated cases of tympanic plate fracture without evidence of other bony fractures. Cone-beam computed tomography is an investigative three-dimensional imaging modality that can be used to detect fine structures and fractures in maxillofacial trauma. This article presents four cases of isolated tympanic plate fracture diagnosed by cone-beam computed tomography with no evidence of fracture involving other bones and review of the literature.

• 한국임상수의학회지
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• 제20권4호
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• pp.523-526
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• 2003

Three dimensional computed tomographic images were obtained in two cases with trauma. The first case of a 3 year-old male Maltese, with ataxia and head tilting due to head trauma was referred to veterinary medical teaching hospital, Seoul National University. Remarkable findings were not found on survey radiographs. With the help of three-dimensional reconstruction computed tomographic imaging, parietal and occipital bone fracture was identified. The second case of 4 month-old female Yorkshire terrier with left forelimb lameness was referred right after trauma. Survey radiography showed obvious incongruity of the elbow joint. Lateral and medial condyle of the left humerus fracture and lateral displacement of the left ulna were apparent in three-dimensional computed tomographic image. It was considered that three-dimensional computed tomography could be used as an aid modality for the exact evaluation of extends and degree of fracture as well as planning of orthopedic surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.303-308
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• 2022

Objectives: Selection of treatment methods for mandibular condylar fractures remains controversial. In this study, we investigated treatment methods for condylar fractures to determine the indications for open or closed reduction. Patients and Methods: Patients >12 years of age treated for mandibular condylar fractures with a follow-up period of ≥3 months were included in this study. The medical records of enrolled patients were reviewed for sex, age, fracture site, treatment method (open or closed reconstruction), postoperative intermaxillary fixation period, operation time, and complications. Radiological analysis of fracture fragment displacement and changes in ramal height difference was performed using computed tomography and panoramic radiography. Results: A total of 198 patients was investigated, 48.0% (n=95) of whom underwent closed reduction and 52.0% (n=103) underwent open reduction. There was no significant correlation between reduction method and patient sex, age, or follow-up period. No statistically significant difference between the incidence of complications and treatment method was observed. None of the patients underwent open reduction of condylar head fracture. Binary logistic regression analysis showed that open reduction was significantly more frequent in patients with subcondylar fracture compared to in those with a fracture in the condylar head area. There was no statistically significant correlation between the groups and fracture fragment displacement. However, there was a significant difference between the treatment groups in amount of change in ramal height difference between the fractured and the non-fractured sides during treatment. Conclusion: No significant clinical differences were found between the open and closed reduction methods in patients with mandibular condylar fractures. According to fracture site, closed reduction was preferred for condyle head fractures. There was no significant relationship between fracture fragment displacement and treatment method.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권1호
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• pp.99-107
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• 2008

Objective : The objective of this review was to provide reliable comparative results regarding the effectiveness of any interventions either open or closed that can be used in the management of fractured mandibular condyle Patients and Methods : Research of studies from MEDLINE and Cochrane since 1990 was done. Controlled vocabulary terms were used. MeSH Terms were "Mandibular condyle" AND "Fractures, bone". Only comparative study were considered in this review using the "limit" function. According to the criteria, two review authors independently assessed the abstracts of studies resulting from the searches. The studies were divided according to some criteria, and following were measured: Ramus height, condyle sagittal displacement, condyle Towns's image displacement, Maximum open length, Protrusion & Lateral excursion, TMJ pain, Malocclusion, and TMJ disorder. Results : Many studies were analyzed to review the post-operative result of the two methods of treatment. Ramus height decreased more in when treated by closed reduction as opposed to open reduction. Sagittal condyle displacement was shown to be greater in closed reduction. Condyle Town's image condyle displacement had greater values in closed reduction. Maximum open length showed lower values in closed reduction. In protrusive and lateral movement, closed reduction was less than ORIF. Closed reduction showed greater occurrence of malocclusion than ORIF. However, post-operative pain and discomfort was greater in ORIF. Conclusion : In almost all categories, ORIF showed better results than CRIF. However, the use of the open reduction method should be considered due to the potential surgical morbidity and increased hospitalization time and cost. To these days, Endoscopic surgical techniques for ORIF (EORIF) are now in their infancy with the specific aims of eliminating concern for damage to the facial nerve and of reducing or eliminating facial scars. Before performing any types of treatment, patients must be understood of both of the treatment methods, and the best treatment method should be taken on permission.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.331-335
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• 2017

Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권6호
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• pp.376-380
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• 2013

Frey syndrome is a disease characterized by abnormal sweating, facial redness, and rare pain by stimulation of taste sense on the limited area dominated by the auriculotemporal nerve and great auricular nerve. Although the developmental mechanism and histopathologic cause of Frey syndrome are still being debated, the most reliable theory is based on injury of the parathympathetic nerve connected to the auriculotemporal nerve continuing to abnormal regeneration. The other theory is that the sweat glands develop an increased sensitivity after degeneration of sympathetic fibers. Therapy of Frey syndrome includes drugs, radiographic treatment, and surgical treatment; however, in most cases, treatment is not satisfactory. This is a case report on a 24-year-old male patient with Frey syndrome caused by the fracture reduction with retromandibular approach after multiple facial traumas and spontaneous healing without any special treatment.

• Journal of Yeungnam Medical Science
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• 제20권2호
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• pp.177-186
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• 2003

교통사고의 증가로 심한 경골 고평부 골절이 점진적으로 증가되는 양상이며, 경골 고평부 골절 후 동반손상의 적절한 치료, 해부학적 정복 및 견고한 고정, 조기 관절운동이 좋은 예후를 보이며 외상성 관절염을 줄일 수 있을 것으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.24.1-24.7
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• 2016

Background: This study aimed to evaluate the structural changes of temporomandibular joint immediately after condylar fractures with magnetic resonance imaging (MRI). Method: We evaluated 34 subjects of condylar fractures with MRI. The position, shape, and signal intensity of the condyle, disc, and retrodiscal tissue were analyzed with MR images. Results: Immediately after trauma, the disc was displaced with the fractured segment in almost all cases. And, the changes of signal intensity at the retrodiscal tissue were found but less related to the degree of fracture displacement. And, the high signals were observed almost at all fractured joint spaces and even at some contralateral joints. Conclusions: The displaced disc as well as the increased signal intensity of the joint space, condylar head, and retrodiscal tissue demands more attention to prevent the possible sequela of joint.

• Imaging Science in Dentistry
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• 제41권2호
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• pp.53-57
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• 2011

Purpose : The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Materials and Methods : Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student�fs t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Results : Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Conclusion : Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

• Imaging Science in Dentistry
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• 제39권4호
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• pp.205-208
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• 2009

Aneurysmal bone cyst (ABC) is relatively rare, non-neoplastic expansile lesion of bone. The case of a IS-year-old male with a ABC of the left mandibular condyle is presented. Panoramic radiograph showed a unilocular radiolucency with thinned coritces and a subcondylar fracuture which was due to the trauma. Computed tomography (CT) revealed expansile lesion which had similar attenuation soft tissue. The patient was treated surgically including iliac crestal bone graft.