Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India.
Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, India.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2023 May;135(5):596-613. doi: 10.1016/j.oooo.2022.09.003. Epub 2022 Sep 8.
The recent trend favors the open reduction and internal fixation of condylar fractures to prevent long-term consequences. Nonendoscopic intraoral approach is an option for management without a visible scar. The purpose of this systematic review was to explore the evidence, armamentarium, methods of reduction and fixation, challenges, and complications.
We have systematically reviewed published articles on the intraoral approach for condylar fracture management following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane library database, to find relevant articles from January 1980 to March 2022. Descriptive statistics were applied to obtain the results.
Finally, 23 studies were included. The incision described for the intraoral approach was similar to sagittal split osteotomy in all studies. A wide array of specialized instruments, methods, and challenges has been outlined for visualization, reduction, and fixation. The incidence of complications in the entire review was 23% (72/306).
The challenges encountered in the nonendoscopic intraoral approach for condylar fracture management can be negated with the use of specialized instruments and with experience. However, further research is warranted for a specialized set of miniature instruments to ease the procedure, make it time-efficient and optimize hardware selection.
最近的趋势倾向于对髁突骨折进行切开复位内固定，以预防长期后果。非内镜经口内入路是一种无可见疤痕管理的选择。本系统评价的目的是探讨证据、设备、复位和固定方法、挑战和并发症。
我们按照系统评价和荟萃分析的首选报告项目指南，对髁突骨折管理的经口内入路的已发表文章进行了系统回顾。在 PubMed、Google Scholar、Semantic Scholar 和 Cochrane 图书馆数据库中进行了搜索，以找到 1980 年 1 月至 2022 年 3 月的相关文章。应用描述性统计方法获得结果。
最终纳入了 23 项研究。所有研究中，经口内入路的切口与矢状劈开截骨术相似。已经概述了广泛的专门仪器、方法和挑战，用于可视化、复位和固定。整个综述中并发症的发生率为 23%（72/306）。
使用专门的仪器和经验可以消除非内镜经口内入路治疗髁突骨折管理中遇到的挑战。然而，需要进一步的研究来开发一套专门的微型仪器，以简化手术过程，提高效率并优化硬件选择。
