scholarly journals Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures

2016 ◽  
Vol 49 (01) ◽  
pp. 59-65 ◽  
Author(s):  
Rajasekhar Gali ◽  
Sathya Kumar Devireddy ◽  
Kishore Kumar Rayadurgam Venkata ◽  
Sridhar Reddy Kanubaddy ◽  
Chaithanyaa Nemaly ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Open Reduction ◽  
Clinical Case ◽  
Mandibular Condyle ◽  
Minimal Risk ◽  
Anatomical Reduction ◽  
Case Record ◽  
Condylar Head ◽  
Free Grafting ◽  
Condylar Fractures

ABSTRACT Introduction: Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. Purpose: This retrospective clinical case record study was done to evaluate the preauricular transmasseteric anteroparotid (P-TMAP) approach for open reduction and extracorporeal fixation of displaced and dislocated high condylar fractures of the mandible. Patients and Methods: This retrospective study involved search of clinical case records of seven patients with displaced and dislocated high condylar fractures treated by open reduction and extracorporeal fixation over a 3-year period. The parameters assessed were as follows: a) the ease of access for retrieval, reimplantation and fixation of the proximal segment; b) the postoperative approach related complications; c) the adequacy of anatomical reduction and stability of fixation; d) the occlusal changes; and the e) TMJ function and radiological changes. Results: Accessibility and visibility were good. Accurate anatomical reduction and fixation were achieved in all the patients. The recorded complications were minimal and transient. Facial nerve (buccal branch) palsy was noted in one patient with spontaneous resolution within 3 months. No cases of sialocele or Frey's syndrome were seen. Conclusion: The P-TMAP approach provides good access for open reduction and extracorporeal fixation of severely displaced condylar fractures. It facilitates retrieval, transplantation, repositioning, fixing the condyle and also reduces the chances of requirement of a vertical ramus osteotomy. It gives straight-line access to condylar head and ramus thereby permitting perpendicular placement of screws with minimal risk of damage to the facial nerve.

scholarly journals Transmasseteric antero-parotid approach through modified preauricular lazy ‘S’ incision for management of mandible condylar fractures: a prospective study

2018 ◽  
Vol 1 (1) ◽  
pp. 85-89
Author(s):  
Kusuma Duda ◽  
Gaddipati R ◽  
Ramsetti S ◽  
Suvvada B
Keyword(s):  
Facial Nerve ◽  
Prospective Study ◽  
Closed Reduction ◽  
Open Reduction ◽  
Condylar Fracture ◽  
Anatomic Reduction ◽  
Operative Complications ◽  
Preauricular Approach ◽  
A Prospective Study ◽  
Condylar Fractures

To report the surgical details and results of our technique of Transmasseteric antero-parotid approach (TMAP) through modified preauricular lazy ‘S’ incision for management of mandibular condylar fractures. This was an observational analysis of 65 patients where 25 patients were treated with conventional preauricular approach, 25 patients with closed reduction and 15 patients with a mean age of 29.4 years with condylar fractures were treated by TMAP technique between September 2016 to June 2018. Aim of the study was to evaluate the proficiency of TMAP approach for open reduction and internal fixation (ORIF) of condylar fracture. The only complication which was noticed was sialocele formation and managed by drainage. TMAP is versatile since it avoids facial nerve damage as it involves identification and preservation of facial nerve and   has less chances of post-operative complications related to facial nerve injury. The accessibility achieved by this approach is fair enough to facilitate anatomic reduction and fixation of condyle.

scholarly journals Retromandibular Approach as a Method for Open Reduction and Internal Fixation of Mandibular Condyle Fractures. Experience in the Regional Hospital 1º de Octubre, ISSSTE and Literature Review

2021 ◽  
Vol 7 (7) ◽  
Author(s):  
González MGR ◽  
Munguía AMN ◽  
González CASJ ◽  
Tellez EB ◽  
Montes IDG
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Surgical Techniques ◽  
Mandibular Condyle ◽  
Middle Cranial Fossa ◽  
Sufficient Evidence ◽  
Mandibular Fractures ◽  
Open Treatment ◽  
Condylar Fractures

Mandibular condyle fractures constitute 17.5% to 52% of mandibular fractures. Open reduction with internal fixation and closed reduction are described for their treatment. Fonseca describes the absolute indications for open treatment when there is displacement of the mandibular condyle to the middle cranial fossa, foreign body invasion, extra capsular displacement of the condyle, and/or malocclusion not susceptible to closed reduction. It includes indications with vast evidence for open treatment of bicondyle fractures, condylar displacement greater than 45 degrees, reduction in the height of the mandibular ramus greater than or equal to 2mm, fractures associated with fractures of the middle third and when there is unstable occlusion. The above establishes sufficient evidence to perform open treatment in various situations of condylar fractures. Regarding the approach of the mandibular condyle region there are different surgical techniques, such as, the preauricular, retroauricular, submandibular, retromandibular, and rhytidectomy approaches.

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.

scholarly journals Fracture of the Mandibular Condyle

2021 ◽  
pp. 1085-1114
Author(s):  
Vikas Dhupar
Keyword(s):  
Nineteenth Century ◽  
Open Reduction ◽  
Patient Management ◽  
Mandibular Condyle ◽  
Classification Systems ◽  
Condylar Fractures

AbstractCondylar fractures of the mandible have intrigued surgeons for decades. This is because of many reasons which have ranged from difficulty in evaluating to managing condylar fractures which have always courted controversies. There has been an attempt to classify condylar fractures from the mid nineteenth century. During early times most of the classifications were focused on purpose of locating the fracture rather than on treatment. As radiological imagery evolved condylar fractures are better understood and have resulted in a different approach to their management. This resulted in a change of classification systems which are focused on management. At the same time a better understanding of the various approaches to the condylar region along with the improvement of armamentarium has resulted in the shift of management of condylar fractures which at one time was closed to open reduction and fixation. In this chapter the focus is on various classifications systems, evaluation of the patient, management and outcome with various modalities of treatment.

scholarly journals Zygomatic arch osteotomy for open reduction and internal fixation of medially displaced/dislocated condylar head in high condylar fractures

2018 ◽  
Vol 8 (2) ◽  
pp. 311
Author(s):  
Elavenil Panneerselvam ◽  
Saravanan Chellappazham ◽  
Sasikala Balasubramanian ◽  
VB Krishnakumar Raja
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Zygomatic Arch ◽  
Condylar Head ◽  
Condylar Fractures

Management of mandibular condylar fractures by the retromandibular approach – An evaluation of its complications

2021 ◽  
Vol 12 (2) ◽  
pp. 80-85
Author(s):  
Devakumari Shanmugam ◽  
Neil Dominic ◽  
Vijhayapriya Thanasekaran ◽  
Amudha Purushothaman ◽  
Dinesh Sridhar ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
Open Reduction ◽  
Treatment Plan ◽  
Mandibular Condyle ◽  
Mouth Opening ◽  
Mandibular Nerve ◽  
Clinical Parameters ◽  
Marginal Mandibular Nerve ◽  
Condylar Fractures

Background: Mandibular condyle fractures are commonly encountered in the practice of maxillofacial surgeon. Even though being a commonly seen fracture, the fracture condyle of the mandible demands meticulous diagnosis and a tailor made treatment plan for each and every patient. The treatment plan largely depends on the age of the patient and the displacement of the fractured fragment. This retrospective study provides an insight in to the management of fracture mandibular condyle by retromandibular approach. Aims and Objectives: The aim of this study was to evaluate the complications of the retromandibular transparotid approach in surgically operated patients with mandibular condylar fractures. Materials and Methods: A retrospective study was performed by analyzing the treatment records of patients who underwent open reduction and internal fixation (ORIF) by the retromandibular transparotid approach for seven years. Thirty-five patients who fulfilled the criteria were included in the study. Clinical parameters such as marginal mandibular nerve weakness, sialocele, occlusal derangement and decreased mouth opening were recorded during the first, fourth and twelfth weeks postoperatively. The retrieved data were analyzed for complications of the retromandibular approach in the management of mandibular condylar fractures. Results: In patients (N= 35) who underwent ORIF by the retromandibular transparotid approach, findings recorded at the end of the first week included 5 patients with sialocele, 2 patients with derangement of occlusion, 6 patients with restricted mouth opening and 1 patient with marginal mandibular nerve weakness. However, postoperatively, at the end of 4 weeks, the only complication observed was sialocele in 3 patients. Furthermore, at the end of 12 weeks, sialocele had completely resolved in all 3 patients, and they were free of complications. Conclusion: The retromandibular transparotid approach is a reliable and straightforward technique with manageable complications.

scholarly journals Application of cone-beam computed tomography (CBCT) for diagnosis and management of mandibular condyle fractures

2017 ◽  
Vol 13 (3) ◽  
pp. 73-81
Author(s):  
Pradip Acharya ◽  
G Ren ◽  
MR Jaisani ◽  
A Dongol ◽  
RP Yadav ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Mandibular Condyle ◽  
Supplementary Information ◽  
Cone Beam ◽  
Condylar Fracture ◽  
Diagnosis And Management ◽  
Condylar Head ◽  
Condyle Fracture ◽  
Condylar Fractures

 Background: Cone beam computed tomography (CBCT) provides precise imaging of temporomandibular joint anatomy without superimposition and distortion. CBCT is relatively a new imaging modality and used commonly in dental practice.Objective: The aim of this study is to present detailed imaging of   emporomandibular joint in case of condyle fracture using CBCT for its use in diagnosis, surgical planning and evaluation of treatment.Method: In our study, we evaluated 3D - CBCT (three dimensional Cone beam computed tomography) examinations of 18 patients with mandibular condyle fractures. All of the fractures in our cases were overlooked on CBCT, thus providing axial, coronal and para-sagittal imaging of condylar head including 3D dimensional volumetric images of the condyle and surrounding structures.Result: Out of 18 condylar fracture patient’s CBCT, 8 radiographs showed condylar head (intracapsular) fracture, 2 condylar neck, 8 subcondylar fracture. 13 condylar fractures were unilateral and 5 were bilateral fracture. 9 of the condylar fractures were not associated with the mandible fracture. Out of the 9 associated condylar fractures; 3 were associated with symphysis fracture, 4 associated with parasymphysis fracture, 1 associated with body fracture and remaining 1 associated with mandibular angle fracture. 6 of the condylar fracture showed no signs of displacement of the fractured part and among 12 displaced condylar fracture parts 8 medially and 4 laterally displaced recorded in CBCT. All of the patients were given treatment on the basis of CBCT diagnosis and the results obtained from it was clinical satisfactory without complaints.Conclusion: We concluded that CBCT is the latest sophisticated technology which provides clear image of condylar head without superimposition of other structures, presented supplementary information for a more effective diagnosis and management of mandibular condyle fractures. Health Renaissance 2015;13 (3): 73-81

scholarly journals Intraoral Endoscopic Approach for Treatment of Condylar Fractures of the Mandible

2021 ◽  
pp. 1115-1124
Author(s):  
Frank Wilde
Keyword(s):  
Facial Nerve ◽  
Internal Fixation ◽  
Nerve Injury ◽  
Open Reduction ◽  
Endoscopic Approach ◽  
Facial Nerve Injury ◽  
Great Auricular Nerve ◽  
Intraoral Approach ◽  
Condylar Fractures

AbstractThe literature is replete with techniques regarding the open reduction and fixation of the condylar fractures of the mandible. The extraoral approach is preferred by the majority of surgeons in comparison to the intraoral approach. Nevertheless, open reduction and internal fixation by an extraoral approach has the evident risk to cause transient or even permanent facial nerve injury [1–4], leads inevitably to a facial scar [1, 5], and can course salivary fistulas, sialoceles [1, 6], Frey syndrome, or disturbance of the great auricular nerve [1]. In contrast, an intraoral approach is minimizing these abovementioned risks and facial scars can be avoided in general [7, 8].

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