Results of Transmasseteric Anteroparotid Approach for Mandibular Condylar Fractures

Ozkan, Heval Selman; Barış, Şahin; Görğü, Metin; Melikoglu, Cenk

doi:10.1097/scs.0b013e3181f4aef7

Cited by 11 publications

(4 citation statements)

References 10 publications

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“…Therefore, low postoperative activity and inadequate functional training may cause trismus. To prevent postoperative contracture of the masseter muscle, several studies have reported that incision of the masseter muscle should be parallel to the muscle bundle [32,46]. Therefore, these techniques should be considered for indications in older patients.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Complications following Open Reduction and Rigid Internal Fixation of Mandibular Condylar Fracture Using the High Perimandibular Approach

et al. 2023

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The high perimandibular approach is a feasible surgical technique for treating mandibular condylar fractures with open reduction and internal fixation, followed by fewer complications. Temporary trismus is the only postoperative complication that may occur. This study evaluated postoperative complications following open reduction and rigid internal fixation (OR-IF) of mandibular condylar fractures using the high perimandibular approach. Twenty consecutive patients undergoing OR-IF were included in this study. They included 11 male and 9 female patients, of an average age of 58.5 years, all of whom responded to a follow-up call at least 12 months after the surgery. All patients were evaluated for range of mouth opening, postoperative complications, and radiological findings. A statistical analysis of the relationship between range of mouth opening and related clinical parameters at 6 months postoperative evaluation was conducted. The fracture of the condylar neck was associated with a limited range of mouth opening and longer operation time. However, longer operation time was not associated with a limited range of mouth opening. The high perimandibular approach with OR-IF in mandibular condylar fractures is a feasible and safe technique; however, prolonged surgery and mandibular condylar neck fractures could affect the postoperative range of mouth opening.

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Section: Discussionmentioning

confidence: 99%

Postoperative Complications following Open Reduction and Rigid Internal Fixation of Mandibular Condylar Fracture Using the High Perimandibular Approach

et al. 2023

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“…Potential complications and risks associated with the surgical procedure are still a matter of concern for maxillofacial surgeons. [ 9 ] Visibility and access to the fracture line is sometimes very limited in some of the most commonly followed incisions such as Risdon's submandibular, retromandibular incisions, as they are placed far off from the fracture site, demanding strong soft tissue retraction that can also increase the risk of facial nerve damage ranging from 30% to 48%. [ 10 ] Improper access is the cause for oblique angulation of screw placement that can jeopardize the plate adaptability and stability of fixation.…”

Section: Discussionmentioning

confidence: 99%

Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures

Gali

Devireddy

Kumar

et al. 2016

Indian J Plast Surg

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Introduction:Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications.Purpose:This retrospective clinical case record study was done to evaluate the preauricular transmasseteric anteroparotid (P-TMAP) approach for open reduction and extracorporeal fixation of displaced and dislocated high condylar fractures of the mandible.Patients and Methods:This retrospective study involved search of clinical case records of seven patients with displaced and dislocated high condylar fractures treated by open reduction and extracorporeal fixation over a 3-year period. The parameters assessed were as follows: a) the ease of access for retrieval, reimplantation and fixation of the proximal segment; b) the postoperative approach related complications; c) the adequacy of anatomical reduction and stability of fixation; d) the occlusal changes; and the e) TMJ function and radiological changes.Results:Accessibility and visibility were good. Accurate anatomical reduction and fixation were achieved in all the patients. The recorded complications were minimal and transient. Facial nerve (buccal branch) palsy was noted in one patient with spontaneous resolution within 3 months. No cases of sialocele or Frey's syndrome were seen.Conclusion:The P-TMAP approach provides good access for open reduction and extracorporeal fixation of severely displaced condylar fractures. It facilitates retrieval, transplantation, repositioning, fixing the condyle and also reduces the chances of requirement of a vertical ramus osteotomy. It gives straight-line access to condylar head and ramus thereby permitting perpendicular placement of screws with minimal risk of damage to the facial nerve.

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“…However, this technique requires the identification of the facial nerve trunk or its branches, at least two at a time, to allow for surgical access between these branches. This requires advanced dissection skills and confidence in the anatomy of the facial nerves in the buccal and mandibular region [10,11]. Despite meticulous dissection, mild neuropraxia can persist up to 13 months postoperatively, and in cases of a transparotid approach, postoperative sialoceles and salivary fistulas can be a nuisance [3].…”

Section: Discussionmentioning

confidence: 99%

“…Although intraoral reduction is generally accepted for symphyseal and parasymphyseal fractures, there is still some debate regarding the use of the intraoral approach to condylar neck and subcondylar fractures because of the surgical skills and associated hardware required [5]. Although various methods of external approaches to the mandible have been proposed, there are no recent articles addressing the classic Risdon approach [6-11]. The authors have used the Risdon approach for open reduction and internal fixation of condylar fractures, in some cases combined with external threaded Kirschner wire fixation and rubber traction.…”

Section: Introductionmentioning

confidence: 99%

The application of the Risdon approach for mandibular condyle fractures

2013

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BackgroundMany novel approaches to mandibular condyle fracture have been reported, but there is a relative lack of reports on the Risdon approach. In this study, the feasibility of the Risdon approach for condylar neck and subcondylar fractures of the mandible is demonstrated.MethodsA review of patients with mandibular condylar neck and subcondylar fractures was performed from March 2008 to June 2012. A total of 25 patients, 19 males and 6 females, had 14 condylar neck fractures and 11 subcondylar fractures.ResultsAll of the cases were reduced using the Risdon approach. For subcondylar fractures, reduction and fixation with plates was done under direct vision. For condylar neck fractures, reduction and fixation was done with the aid of a trochar in adults and a percutaneous threaded Kirschner wire in children. There were no malunions or nonunions revealed in follow-up care. Mild transient neuropraxia of the marginal mandibular nerve was seen in 4 patients, which was resolved within 1–2 months.ConclusionsThe Risdon approach is a technique for reducing the condylar neck and subcondylar fractures that is easy to perform and easy to learn. Its value in the reduction of mandibular condyle fractures should be emphasized.

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Results of Transmasseteric Anteroparotid Approach for Mandibular Condylar Fractures

Cited by 11 publications

References 10 publications

Postoperative Complications following Open Reduction and Rigid Internal Fixation of Mandibular Condylar Fracture Using the High Perimandibular Approach

Postoperative Complications following Open Reduction and Rigid Internal Fixation of Mandibular Condylar Fracture Using the High Perimandibular Approach

Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures

The application of the Risdon approach for mandibular condyle fractures

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