Condyle Dislocation to Medial Cranial Fossa: A Systematic Review

Abstract

This study aims to investigate the clinical, immunological complications and their relations to each one of the treatment approaches for the traumatic dislocation of the mandibular condyle to the medial cranial fossa. Methods: An electronic literature search was undertaken in June/2021. Eligibility criteria included publications having enough clinical, radiological, treatment protocols, and postoperative outcomes information. Results: 46 publications (50 patients) were included. Most of the patients were women (70%), the most common age range in the pediatric population from 0 to 15 years old (34%). The mean age is 25,66 years old (+-15,19). The most common causes are automotive accidents (60%), Falls (8%), and Assaults (8%), followed by one case of an industrial accident. Otorrhagia was present in 10% of the patients, loss of conciseness in 10% of the patients, followed by 6% presenting intracranial hematoma. Open treatment was preferred by 44%, followed by closed treatment (26%), condylectomy (16%), and conservative treatment (14%). No complications were observed in 60% of the patients. However, complications related to the TMJ were observed in 38% of the cases, followed by 2% of complications related to the medial cranial fossa. Comparative statistical analyzes did not show differences between the treatment modalities as the complications, except when compared with closed treatment with complications related to the medial cranial fossa (p = 0,035). Conclusions: The traumatic dislocation of the mandibular condyle to the medial cranial fossa is a rare complication related to facial trauma, with only fifty cases described in the literature. The treatment modalities did not influence the development of complications, except when the chosen treatment is the closed one when the odds for complications related to the medial cranial fossa are slightly higher.