scholarly journals The Relationship of the Facial Nerve to the Condylar Process: A Cadaveric Study with Implications for Open Reduction Internal Fixation

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
H. P. Barham ◽  
P. Collister ◽  
V. D. Eusterman ◽  
A. M. Terella
Keyword(s):  
Facial Nerve ◽  
Internal Fixation ◽  
Open Reduction ◽  
Mandibular Condyle ◽  
Open Reduction Internal Fixation ◽  
Condylar Process ◽  
Preauricular Approach ◽  
Relationship Of ◽  
The Relationship ◽  
Condylar Neck

Introduction. The mandibular condyle is the most common site of mandibular fracture. Surgical treatment of condylar fractures by open reduction and internal fixation (ORIF) demands direct visualization of the fracture. This project aimed to investigate the anatomic relationship of the tragus to the facial nerve and condylar process.Materials and Methods. Twelve fresh hemicadavers heads were used. An extended retromandibular/preauricular approach was utilized, with the incision being based parallel to the posterior edge of the ramus. Measurements were obtained from the tragus to the facial nerve and condylar process.Results. The temporozygomatic division of the facial nerve was encountered during each approach, crossing the mandible at the condylar neck. The mean tissue depth separating the facial nerve from the condylar neck was 5.5 mm (range: 3.5 mm–7 mm, SD 1.2 mm). The upper division of the facial nerve crossed the posterior border of the condylar process on average 2.31 cm (SD 0.10 cm) anterior to the tragus.Conclusions. This study suggests that the temporozygomatic division of the facial nerve will be encountered in most approaches to the condylar process. As visualization of the relationship of the facial nerve to condyle is often limited, recognition that, on average, 5.5 mm of tissue separates condylar process from nerve should help reduce the incidence of facial nerve injury during this procedure.

scholarly journals Endoscopic-Assisted Intraoral Open Reduction Internal Fixation of Mandibular Subcondylar Fractures: Initial Experiences from a Tertiary-Care Maxillofacial Center in India

2018 ◽  
Vol 11 (3) ◽  
pp. 183-191 ◽  
Author(s):  
Venkatesh Anehosur ◽  
Abhijit Joshi ◽  
Saravanan Rajendiran
Keyword(s):  
Facial Nerve ◽  
Learning Curve ◽  
Internal Fixation ◽  
Open Reduction ◽  
Tertiary Care ◽  
Mouth Opening ◽  
Open Reduction Internal Fixation ◽  
Steep Learning Curve ◽  
Intraoral Approach ◽  
Condylar Fractures

Management of condylar fractures is a highly controversial and debatable area. Open reduction and internal fixation (ORIF) using an extraoral approach has certain benefits over the nonsurgical treatment. Risk of damage to the facial nerve and an extraoral scar remains constant deterrents. An endoscopic-assisted ORIF offers an intraoral approach, thus eliminating consequences such as scarring. Though this technique offers unparalleled advantages, it is associated with a steep learning curve. Surgical results improve only with patience and experience. Patients with condylar fractures reported to SDM Craniofacial Unit, Dharwad, India, from 2013 to 2015 are included. Patients were treated with endoscopic-assisted ORIF and were evaluated for functional outcomes that included occlusion, maximal interincisal opening, and deviation of mouth and complications such as facial nerve pareses, postsurgical infection, and morbidity. Fifteen patients included in the study: 4 left sided and 11 right sided fractures. Nine patients had associated other mandibular fracture. Mean age of the patients was 28.2 years. Mean mouth opening at the end of 1 week, 6 weeks, and 6 months was 32.6, 37.8, and 40.5 mm, respectively. Transient facial nerve pareses were noted in one patient, and an extraoral draining sinus was noted in another. Endoscopic-assisted ORIF has a definite scope in management of condylar fractures. Results are more predictable with appropriate case selection due to a steep learning curve and intraoperative technical challenges. An initial experience in ORIF using extraoral approaches would greatly benefit a surgeon in utilizing this novel and alternate tool.

Surgical Anatomy for Extended Facelift Techniques

2020 ◽  
Vol 36 (03) ◽  
pp. 309-316
Author(s):  
Ozcan Cakmak ◽  
Ismet Emrah Emre
Keyword(s):  
Facial Nerve ◽  
Soft Tissues ◽  
Extended Techniques ◽  
Surgical Anatomy ◽  
Superficial Musculoaponeurotic System ◽  
Increased Risk ◽  
The Face ◽  
Facial Soft Tissues ◽  
Relationship Of ◽  
The Relationship

AbstractPreservation of the facial nerve is crucial in any type of facial procedure. This is even more important when performing plastic surgery on the face. An intricate knowledge of the course of the facial nerve is a requisite prior to performing facelifts, regardless of the technique used. The complex relationship of the ligaments and the facial nerve may put the nerve at an increased risk of damage, especially if its anatomy is not fully understood. There are several danger zones during dissection where the nerve is more likely to be injured. These include the areas where the nerve branches become more superficial in the dissection plane, and where they traverse between the retaining ligaments of the face. Addressing these ligaments is crucial, as they prevent the transmission of traction during facelifts. Without sufficient release, a satisfying pull on the soft tissues may be limited. Traditional superficial musculoaponeurotic system techniques such as plication or imbrication do not include surgical release of these attachments. Extended facelift techniques include additional dissection to release the retaining ligaments to obtain a more balanced and healthier look. However, these techniques are often the subject of much debate due to the extended dissection that carries a higher risk of nerve complications. In this article we aim to present the relationship of both the nerve and ligaments with an emphasis on the exact location of these structures, both in regard to one another and to their locations within the facial soft tissues, to perform extended techniques safely.

scholarly journals Evaluation of Factors Driving Cost Variation for Distal Humerus Open Reduction Internal Fixation

2020 ◽  
Author(s):  
Michelle Zeidan ◽  
Andrew R. Stephens ◽  
Chong Zhang ◽  
Angela P. Presson ◽  
Andrew R. Tyser ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Distal Humerus ◽  
Open Reduction Internal Fixation ◽  
Cost Variation

scholarly journals Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis and Open Reduction Internal Fixation on Proximal Humeral Fracture in Elder Patients: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Zhao ◽  
Yuhui Zhang ◽  
Dongni Johansson ◽  
Xingyu Chen ◽  
Fang Zheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humeral Fracture ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Humeral Fracture ◽  
Open Reduction Internal Fixation ◽  
Elder Patients

Objective. The study aims to compare minimally invasive percutaneous plate osteosynthesis (MIPO) and open reduction internal fixation (ORIF) in the treatment of proximal humeral fracture in elder patients. Method. PubMed, Medline, EMbase, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wangfang, and VIP Database for Chinese Technical Periodicals were searched to identify all relevant studies from inception to October 2016. Data were analyzed with Cochrane Collaboration’s Review Manage 5.2. Results. A total of 630 patients from 8 publications were included in the systematic review and meta-analysis. The pooled results showed that MIPO was superior to ORIF in the treatment of proximal humeral fracture in elder patients. It was reflected in reducing blood loss, operation time, postoperative pain, or fracture healing time of the surgery and in improving recovery of muscle strength. Concerning complications, no significant difference was seen between MIPO and ORIF. Conclusion. The MIPO was more suitable than ORIF for treating proximal humeral fracture in elder patients.

Complications of the Transmasseteric Anteroparotid Approach for Subcondylar Fractures: A Retrospective Study

2021 ◽  
pp. 194338752110169
Author(s):  
Jared Gilliland ◽  
Fabio Ritto ◽  
Paul Tiwana
Keyword(s):  
Retrospective Study ◽  
Facial Nerve ◽  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Mouth Opening ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
University Of Oklahoma ◽  
The University

Study Design: A retrospective analysis of patients with subcondylar fractures treated via a transmasseteric anteroparotid approach by the Oral and Maxillofacial Department at the University of Oklahoma. Objective: The goal of this study was to evaluate complications, morbidity, and safety with the transmasseteric anteroparotid approach for treatment of subcondylar fractures, and compare it to other findings previously reported in the literature. Methods: A retrospective study was conducted that consisted of 23 surgically treated patients in the past 2 years for subcondylar fractures. Only patients with pre-operative malocclusion and who underwent open reduction with internal fixation with the transmasseteric anteroparotid (TMAP) approach were included. Exclusion criteria included 1) patients treated with closed reduction 2) patients who failed the minimum of 1, 3, and 6-week post-operative visits. The examined parameters were the degree of mouth opening, occlusal relationship, facial nerve function, incidence of salivary fistula and results of imaging studies. Results: 20 of the surgically treated patients met the inclusion criteria. Two patients were excluded due to poor post-operative follow up and 1 was a revision of an attempted closed reduction by an outside surgeon that presented with pre-existing complications. There were no cases of temporary or permanent facial nerve paralysis reported. There were 3 salivary fistulas and 2 sialoceles, which were managed conservatively and resolved within 2 weeks, and 2 cases of inadequate post-surgical maximal incisal opening (<40 mm) were observed. Conclusion: The transmasseteric anteroparotid approach is a safe approach for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.

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