Tomar Kapil
Naval Institute of Dental Sciences, RC Church, Colaba, Mumbai, 400005 India.
J Maxillofac Oral Surg. 2018 Sep;17(3):332-338. doi: 10.1007/s12663-017-1022-y. Epub 2017 May 29.
Fractures of the mandible subcondyle have always presented a challenge to the maxillofacial surgeon, with a myriad of treatment options existing ranging from conservative management to open reduction and internal fixation (ORIF) to condylotomy. The complex anatomy of the region poses a challenge, with injury to the facial nerve branches being the primary concern.
This study evaluated the efficacy of a modified retromandibular approach, with retroparotid trans-masseteric dissection for ORIF of subcondylar fractures.
Twenty-five patients with subcondylar fractures at varying levels were treated surgically by ORIF using this approach.
All patients managed by this modified retromandibular approach had satisfactory results with restoration of vertical ramal height, satisfactory mouth opening, stable occlusion and no facial nerve damage post-op.
In our study, the modified retromandibular approach, with retroparotid trans-masseteric approach was effective in surgical management of subcondylar fractures by ORIF with minimal complications.
下颌骨髁突骨折一直是颌面外科医生面临的挑战,存在从保守治疗到切开复位内固定(ORIF)再到髁突切除术等众多治疗选择。该区域复杂的解剖结构带来了挑战,其中面神经分支损伤是主要关注点。
本研究评估了一种改良的下颌后入路联合腮腺后经咬肌入路进行髁突骨折切开复位内固定术的疗效。
25例不同程度髁突骨折的患者采用该入路进行切开复位内固定手术治疗。
所有采用这种改良下颌后入路治疗的患者均取得了满意的效果,垂直升支高度恢复良好,张口度满意,咬合稳定,术后无面神经损伤。
在我们的研究中,改良下颌后入路联合腮腺后经咬肌入路在切开复位内固定治疗髁突骨折方面效果良好,并发症最少。