Comparison Between Two Techniques for the Treatment of Mandibular Subcondylar Fractures: Closed Treatment Technique and Transoral Endoscopic-Assisted Open Reduction

Khiabani, Kazem; Raisian, Shahrokh; Mehmandoost, Meghdad Khanian

doi:10.1007/s12663-014-0644-6

Cited by 17 publications

(12 citation statements)

References 18 publications

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“…In this study, no significant difference was noted in maximum mouth opening between surgically and conservatively treated fractures. Similar results were noted by Santler et al ,[ 14 ] Khiabani et al ,[ 15 ] Haug and Assael. [ 16 ] Although immediate postoperatively maximum mouth opening was significantly higher (26.6 mm ± 1.50 mm) in conservatively treated patients than surgically treated patients (22.66 mm ± 1.54 mm), the patients treated by open methods may have had less mouth opening at 6 weeks because surgery induced some hypomobility due to joint and incisional pain, or possibly because scarring occurred during healing of the surgical site.…”

Section: Discussionsupporting

confidence: 91%

Unilateral condylar fracture with review of treatment modalities in 30 cases - An evaluative study

Patel¹,

Desai²,

Matariya³

et al. 2021

Ann Maxillofac Surg

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Introduction: The treatment of subcondylar mandible fractures is a topic of debate and can be variable even though these fractures are commonly seen. The present study aimed at evaluation of various treatment modalities for unilateral condylar fracture in adults. Materials and Methods: Thirty patients with unilateral condylar fractures between the age of 18 and 60 years were evaluated. Treatment protocol included closed reduction for 15 patients and open reduction for 15 patients. Results: Assessment was done functionally for maximum interincisal mouth opening, deviation on maximum interincisal mouth opening, occlusion and facial nerve function, and radiologically for ramus height shortening. In general, there were no statistically significant differences between closed and open methods. Discussion: Both the treatment options for condylar fractures of the mandible yielded acceptable results. Closed treatment appears to be a safe and appropriate modality for most unilateral condylar fractures. Although the open group, in general, showed similar outcomes, this treatment should be reserved for limited indications. The present study has confirmed that both treatment options can yield acceptable results. On clinical examination, there was no significant difference in mouth opening measures, the incidence of occlusal disturbances or in the degree of pain perception.

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Section: Discussionsupporting

confidence: 91%

Unilateral condylar fracture with review of treatment modalities in 30 cases - An evaluative study

Patel¹,

Desai²,

Matariya³

et al. 2021

Ann Maxillofac Surg

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“…The treatment method is determined by the height of the ramus mandibulae and the angle of deviation of the bone fragment [14,15]. Although the fracture heals fast, some complications interfere with daily life, such as facial scarring, facial nerve paralysis, and ankylosis [16]. Reports suggest using endoscopy equipment and techniques to avoid these issues [17].…”

Section: Discussionmentioning

confidence: 99%

Practical Orthognathic Surgery Approach to the Old Bilateral Mandibular Condylar Head Fractures

2023

J Surg

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Introduction:Fractures of the mandibular condylar head occur frequently and account for 25% to 40% of all mandibular fractures. Treatment includes conservative and surgical methods; however, there is no international consensus on which treatment should be performed. Furthermore, bilateral mandibular condylar head fractures are often accompanied by masticatory disorders due to malocclusion and sleep apnea syndrome due to respiratory disorders, resulting in decreased quality of life and impaired social rehabilitation. The treatment of mandibular condylar head fractures may be delayed when the situation is accompanied by brain or other trauma, and the fractures often become old fractures. This paper will discuss how to treat old bilateral condylar head fractures because very few reports are available. Presentation of Case:A 65-year-old female underwent trauma on the mandibular body after two falls in 2004 and 2016. She experienced fractures of the left side of the mandibular body and both mandibular condyles. The treatment of her thoracic compression fractures was prioritized, and the fractured mandible remained untreated. The patient visited the hospital later in 2020 with complaints of masticatory disorders due to occlusal deficiency and sleep apnea syndrome due to a respiratory disorder. She was diagnosed with old fractures on the left mandibular body and both mandibular condylar heads. The patient's occlusal relationship was Angle Class II with an open bite. She underwent a short-split technique of the Sagittal Split Ramus Osteotomy (SSRO) under general anesthesia. Postoperative improvement of sleep apnea syndrome was observed due to improved occlusal relationship and respiratory distress. One year after the surgery, the mandible showed no relapse, and the patient was in good condition. Conclusion:For old bilateral mandibular condylar head fractures, the short-split method of SSRO used in orthognathic surgery improved the patient's occlusal relationship and facial profile. The airway was expanded, and sleep apnea was resolved. By using this surgical technique, relapse was prevented, and the patient maintained a stable occlusal relationship.

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“…Aboelatta et al33 found a significant improvement in MIO postoperatively. Average MIO is reported in Khiabani et al40 found a greater maximal anterior opening in an endoscopic group compared to an MMF group at 2-and 4-week follow-up.…”

mentioning

confidence: 86%

“…Five studies reported MO as a primary outcome 33,35,36,40,42 . Aboelatta et al 33 found a significant improvement in MIO postoperatively.…”

Section: Endoscopic Approachesmentioning

confidence: 99%

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Current Management of Subcondylar Fractures: A Systematic Review

Shikara

Bridgham

Ludeman

et al. 2023

Otolaryngol.--head neck surg.

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Objective. The aim of this study is to review the current literature on treatment of subcondylar fractures using traditional open reduction internal fixation (ORIF), closed reduction with maxillomandibular fixation (MMF), and endoscopic open approaches.Data Sources. PubMed, Embase, Cochrane CENTRAL, Clinicaltrials.gov, and WHO ICTRP.Review Methods. A comprehensive database search was performed in accordance with PRISMA guidelines. All English-only texts published in the last 20 years with ≥10 patients were included. Studies that included patients <16 years old were excluded.Results. Thirty-two studies met the final inclusion criteria. Nine studies compared ORIF with closed reduction using MMF, 12 studies evaluated ORIF via different approaches, and 10 studies evaluated outcomes after endoscopic approaches. Five studies reported significant improvement in mouth opening with ORIF compared to closed reduction. In 1 study that recorded patient-reported outcomes measure (FACE-Q scale), quality of life scores and patient satisfaction were significantly higher in the ORIF group. Among the 10 studies that used the endoscopic approach, transient facial nerve injury ranged from 0% to 10%. Conclusion.Several studies report better mouth opening, dental occlusion, and functional outcomes after ORIF compared to closed reduction, while some found no significant difference. Endoscopic approaches provide ease of access to the condyle with a low incidence of facial nerve injury. However, limitations include special equipment, longer operative times, and a steep learning curve using an endoscope. This review provides surgeons with an overview of the current literature on subcondylar fractures to allow for an individualized management approach for each patient.

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Comparison Between Two Techniques for the Treatment of Mandibular Subcondylar Fractures: Closed Treatment Technique and Transoral Endoscopic-Assisted Open Reduction

Cited by 17 publications

References 18 publications

Unilateral condylar fracture with review of treatment modalities in 30 cases - An evaluative study

Unilateral condylar fracture with review of treatment modalities in 30 cases - An evaluative study

Practical Orthognathic Surgery Approach to the Old Bilateral Mandibular Condylar Head Fractures

Current Management of Subcondylar Fractures: A Systematic Review

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