Retromandibular approach for reduction and fixation of mandibular condylar fractures: A clinical experience

Narayanan, Vinod; Kannan, R. Jagadeesh; Sreekumar, K

doi:10.1016/j.ijom.2009.04.008

Cited by 60 publications

(26 citation statements)

References 20 publications

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“…Different intraoral and extraoral approaches to the condylar area are used to perform open reduction of condyle fractures including submandibular, perimandibular, preauricular, and retromandibular approaches (Tang and Gao, 2009;Handschel et al, 2012). Several studies regarding the advantages and the complications of the retromandibular approach can be found in literature (Devlin et al, 2002;Biglioli et al, 2009;Narayanan et al, 2009;Girotto et al, 2012;Kim et al, 2012;Bhutia et al, 2014;Colletti et al, 2014). Despite the elevated number of investigations, publications with consistent case numbers of more than 50 patients are rare (Bouchard et al, 2014;Colletti and Battista, 2014).…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of mandibular condyle fractures using the retromandibular anterior transparotid approach and a triangular-positioned double miniplate osteosynthesis technique: A clinical and radiological evaluation of 124 fractures

Torre

Burtscher

Widmann

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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Section: Introductionmentioning

confidence: 99%

Surgical treatment of mandibular condyle fractures using the retromandibular anterior transparotid approach and a triangular-positioned double miniplate osteosynthesis technique: A clinical and radiological evaluation of 124 fractures

Torre

Burtscher

Widmann

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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“…Fixing the fractured head to the free ramal graft without detaching the lateral pterigoid [4] will be difficult to reposition due to intervening soft tissues. Explanted fractured segment act as free graft [13][14][15] and shows condylar resorption [4,13]. In our case followup was only for three months and it is very early to comment on condylar resorption.…”

mentioning

confidence: 62%

“…As most of the surgeons used miniplates [11,12] while fixing the fractured segment we differed due to comminuted fracture of the head and also partial loss of segment. We have done wire osteosynthesis [11][12][13] to preserve more volume of bone and helps in good union. After fixing it in the precise plane, the patient's mouth opening was perfect.…”

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confidence: 99%

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Extra Corporeal Fixation of Fractured Mandibular Condyle

Kannadasan

Kengagsubbiah

et al. 2014

JCDR

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A 27-year-old male patient reported to our casualty with a history of fall from motor cycle about five days back and was seen by the medical officers in a hospital elsewhere. After the first-aid he reported to our hospital with a complaint of pain on the left side of jaw and deviation of jaw to the left side during mouth opening. On examination a young well-built and nourished male who was conscious, well oriented and was able to recall the incident clearly. Face was symmetrical and there was healed abrasions seen on the left temple area and left zygomatic area and sutured laceration on the right side of the chin area. A healed scar seen on the left side of the upper lip extending from the columella to the left ala. Intra-orally all teeth were present except right lower third molar. Right upper central incisor and lateral incisor were fractured with Elli's class II and class III respectively. Deranged occlusion seen on the right side [Table/ Fig-1]. Mandible found to be deviated to the left with restricted mouth opening. On palpation the left side Temporomandibular joint (TMJ) area was soft and condyle could not be elicited. OPG shows left high condylar fracture [Table/ Fig-2]. CT showed anteromedial dislocation of the fractured medial half of the head of the left condyle, found to be displaced to the level of sigmoid notch .As the fracture fragment was dislocated more antero medially, we decided to go for extracorporeal reduction and fixation, as the pre auricular or retro-mandibular will not give adequate exposure. Patient's routine blood investigations were normal. Neurosurgical clearance sought as the patient history showed loss of conscious for 10 min at the time of accident. After obtaining fitness patient In superior or high condylar fractures,exact reduction with conventional open reduction can be difficult due to the limited surgical and visual fields. In such cases extracorporeal fixation of condyle using vertical ramus osteotomy may be better choice to achieve perfect alignment and absolute maintaince of vertical height of the ramus and facial symmetry. We here present a case of extracorporeal fixation of unilateral left high condylar fracture.was submitted to GA under Naso-Endotracheal intubation, First Inter-maxillary fixation (IMF) done to achieve normal occlusion for later placement of osteotomised segment in the proper anatomical location. Risdon Incision was placed through submandibular approach. After dividing the platysma the parotid and Masseter junction exposed. The area next to the anterior edge of the parotid gland is usually relatively free of branches of facial nerve, making this an ideal point to dissect down to the fracture. After carefully dissecting and retracting the parotid, masseter muscle divided at the angle. By sub periosteal dissection the sigmoid notch exposed and retractor placed. Four hole stainless steel mini plate without gap two in number were adapted over pre-planned osteotomy site on the lateral surface of the ramus. Plates and screws were removed and preserved. Osteot...

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“…Retromandibular approach was used in our study because it provides good access and allows direct visual alignment of the fracture fragments [11], it exposes the entire ramus from behind and is therefore useful for procedures involving the area on or near the condylar neck/ head, or the ramus itself [1]. The other advantages of this approach include reduced distance from skin incision to the area of interest [12], minimally invasive, useful for low subcondylar fractures, less conspicuous facial scar [13], good cosmetic result and no need to use transcutaneous trocar because the tissues can be retracted superiorly and anteriorly to the level of the sigmoid notch with this approach [1]. The retromandibular approach has been favored by many authors as this provides an excellent exposure of the fractured site.…”

Section: Discussionmentioning

confidence: 99%

Management of Mandibular Sub Condylar and Condylar Fractures Using Retromandibular Approach and Assessment of Associated Surgical Complications

Bindra

Choudhary

Sharma

et al. 2010

J. Maxillofac. Oral Surg.

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Retromandibular approach for reduction and fixation of mandibular condylar fractures: A clinical experience

Cited by 60 publications

References 20 publications

Surgical treatment of mandibular condyle fractures using the retromandibular anterior transparotid approach and a triangular-positioned double miniplate osteosynthesis technique: A clinical and radiological evaluation of 124 fractures

Surgical treatment of mandibular condyle fractures using the retromandibular anterior transparotid approach and a triangular-positioned double miniplate osteosynthesis technique: A clinical and radiological evaluation of 124 fractures

Extra Corporeal Fixation of Fractured Mandibular Condyle

Management of Mandibular Sub Condylar and Condylar Fractures Using Retromandibular Approach and Assessment of Associated Surgical Complications

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