Department of Oral and Maxillofacial Surgery, Academic Medical Center of Amsterdam, University of Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Surgery, Academic Medical Center of Amsterdam, University of Amsterdam, The Netherlands.
J Craniomaxillofac Surg. 2018 Aug;46(8):1232-1240. doi: 10.1016/j.jcms.2018.04.020. Epub 2018 May 18.
There is considerable controversy about whether condylar fractures should be treated open or closed. Even when there is a clear indication for open treatment, the appropriate approach opens another debate.
To provide a clear overview on the complications of extraoral approaches to condylar fractures.
Systematic literature search of all indexed years on PubMed, Medline, and Embase. For detailed analysis, we selected 70 studies.
Of the 2783 patients who were studied with respect to facial nerve function, 338 (12%) experienced some form of weakness. Most (95%) achieved full recovery. In 17 of the 338 patients (5%), these paralyses were permanent. A hematoma occurred in 1.7%, an infection of the wound in ≥2.9%, Frey syndrome in 1.1%, a sialocele in 2.6%, a salivary fistula in ≥4.8%, sensory disturbance of the great auricular nerve in 7.9%, and an unsatisfactory scar in ≥1.6% of the patients.
Due to the great diversity in fractures, approaches, and surgical techniques, it is difficult to objectively compare surgical techniques for condylar fractures and their complications. Based on the literature studied in this review, we propose a treatment protocol with respect to open treatment approaches.
对于髁突骨折是否应采用开放或闭合治疗存在较大争议。即使有明确的开放治疗指征，合适的治疗方法也会引发另一场争论。
提供有关髁突骨折经口内入路治疗并发症的清晰概述。
对 PubMed、Medline 和 Embase 所有索引年份进行系统文献检索。为了进行详细分析，我们选择了 70 项研究。
在研究面神经功能的 2783 名患者中，338 名（12%）出现某种形式的无力。大多数（95%）患者完全恢复。在 338 名患者中的 17 名（5%），这些瘫痪是永久性的。血肿发生率为 1.7%，伤口感染发生率≥2.9%，Frey 综合征发生率为 1.1%，涎瘘发生率为 2.6%，唾液囊肿发生率为 2.6%，耳大神经感觉障碍发生率为 7.9%，瘢痕不满意发生率≥1.6%。
由于骨折、入路和手术技术的多样性很大，因此很难客观比较髁突骨折及其并发症的手术技术。基于本综述研究的文献，我们提出了一种开放治疗方法的治疗方案。
