Department of Plastic, Reconstructive and Maxillofacial Surgery, Henri Mondor Hospital, UPEC, University Paris Est Créteil, Val de Marne, 51 Avenue du Marechal de Lattre de Tassigny, 94000, Créteil, France.
University of Lille, Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille, INSERM U 1008, Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France.
J Craniomaxillofac Surg. 2018 Dec;46(12):2256-2260. doi: 10.1016/j.jcms.2018.10.011. Epub 2018 Oct 19.
The purpose of our anatomical study was to compare the accessibility of the area at the level of the neck of the condyle and the condylar head by two different approaches: the modified Risdon approach and a transparotid approach by rhytidectomy (TPAR).
An anatomical study was performed on 12 heads of cadavers preserved with a solution rich in glycerin and ethanol, but very low in formalin. A modified Risdon approach and a TPAR were each performed on a hemiface of the same head. The bone surface was rendered digitally accessible on an anatomical diagram using Image J software. The software was used to determine a concordance score between the area of accessibility and the area of interest necessary for osteosynthesis of a high subcondylar fracture. This score was presented as a numerical scale from 0 to 100. We measured the total number of pixels in our area of interest and assigned it a score of 100. We then compared the area of accessibility with the area of interest necessary for osteosynthesis of a high subcondylar fracture.
Using the modified Risdon approach, an average score of 55.88 (SD = 18.96) was found, or 55.88% of the accessible area of interest. Using TPAR, we found a score of 91.05 (SD = 7.95) or 91.05% of the accessible area of interest. This difference in score between the two techniques was significantly different (p < 0.001), taking into account intra-hemiface and intra-individual correlation.
TPAR seems to be more effective in treating high condylar process fractures of the mandible.
我们解剖学研究的目的是通过两种不同的方法来比较髁颈和髁突头区域的可及性：改良 Risdon 入路和经除皱术的透明皮入路（TPAR）。
我们在 12 个用富含甘油和乙醇但福尔马林含量非常低的溶液保存的尸体头颅上进行了解剖学研究。在同一头颅的一半面上分别进行改良 Risdon 入路和 TPAR。使用 Image J 软件在解剖图上对骨表面进行数字化处理，以获得可及区域与高髁突下骨折所需的感兴趣区域之间的一致性评分。该评分以 0 到 100 的数字量表表示。我们测量了感兴趣区域的总像素数，并将其赋值为 100。然后，我们将可及区域与高髁突下骨折所需的感兴趣区域进行比较。
使用改良 Risdon 入路，平均评分为 55.88（SD=18.96），即 55.88%的感兴趣区域可及。使用 TPAR，我们发现评分为 91.05（SD=7.95）或 91.05%的感兴趣区域可及。这两种技术之间的评分差异具有统计学意义（p<0.001），考虑到半面内和个体内的相关性。
TPAR 似乎更有利于治疗下颌骨高位髁突骨折。
