Colangeli Walter, Lo Faro Carmelo, Cordaro Raffaella, Novembre Daniela, Barca Ida, Becelli Roberto, Cristofaro Maria Giulia
Ann Ital Chir. 2019;90:244-251.
We evaluated the safety and efficacy using a mini-retromandibular transparotid approach to reduce and rigidly fix displaced mandibular condylar neck fractures.
Retrospective evaluation of patients who underwent surgical reduction of condylar fracture from January 2012 to December 2014 at the Department of Cranio Maxillo-Facial Surgery of the University Hospital of Catanzaro, Italy. All the patients were clinically assessed for signs/symptoms of infection, signs of Frey's syndrome or salivary fistula, facial nerve palsy ,postoperative scar, TMJ function, and occlusion with range of mouth opening and deviation.
The sample was composed of 15 patients. Good results were achieved in all patients and with an average follow- up of 20 months. No major intraoperative or postoperative complication remained at 6 months of postoperative follow- up.
Management of condylar fractures is still one of the most controversial topics in maxillofacial surgery. Regarding our experience with the mini-retromandibular approach, we evaluate the advantages in comparison with other extra-oral approaches. Advantages include the shorter working distance from the skin incision to the condyle with direct alignment of the fractured segments, less conspicuous facial surgical scarring with good cosmetic result, short operation time, with a low risk of postoperative complications and possible injuries of the facial nerve.
According to our results, we believe that the mini-retro-mandibular approach is a viable and safe approach for the surgical treatment of condylar fractures, with a relatively low risk of postoperative complications.
Condylar fracture, Extraoral approach, Mini-retromandibular access.
我们评估了采用下颌后凹小切口经腮腺入路来复位并牢固固定下颌髁突颈部移位骨折的安全性和有效性。
对2012年1月至2014年12月在意大利卡坦扎罗大学医院颅颌面外科接受髁突骨折手术复位的患者进行回顾性评估。所有患者均接受了关于感染体征/症状、弗雷综合征或涎瘘体征、面神经麻痹、术后瘢痕、颞下颌关节功能以及开口度和偏斜度时咬合情况的临床评估。
样本包括15名患者。所有患者均取得了良好效果，平均随访20个月。术后6个月的随访中未出现重大术中或术后并发症。
髁突骨折的治疗仍是颌面外科中最具争议的话题之一。基于我们在下颌后凹小切口入路方面的经验，我们评估了其与其他口外入路相比的优势。优势包括从皮肤切口到髁突的工作距离较短，骨折段可直接对合，面部手术瘢痕不明显，美容效果良好，手术时间短，术后并发症风险低以及面神经损伤可能性小。
根据我们的结果，我们认为下颌后凹小切口入路是一种可行且安全的髁突骨折手术治疗方法，术后并发症风险相对较低。
髁突骨折；口外入路；下颌后凹小切口入路
