J Korean Cleft Palate-Craniofac Assoc.  2008 Apr;9(1):17-22.

Consideration of Clinical Progress after Open Reduction with Retromandibular Approach in Treatment of Mandibular Condyle Fractures

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, College of Medicine, Chung-Ang University, Seoul, Korea. hkkiim@cau.ac.kr

Abstract

PURPOSE
For several decades, open reduction has been a controversial issue in mandibular condyle fracture. The authors have successfully used the open reduction and internal fixation with retromandibular approach and have found it to be satisfactory for mandibular condyle fracture.
METHODS
A total of 10 patients with mandibular condyle fracture underwent open surgical treatment using retromandibular approach. The incision for the retromandibular approach was carried below the ear lobe and the facial nerve branches were identified. Dissection was continued until the fracture site was exposed and internal fixation was performed with miniplate following intermaxillary fixation. The average period of joint immobilization was 1 weeks and the arch bars were removed in 3 weeks on average. The preoperative and postoperative panoramic view and three-dimensional computed tomography were compared. During the follow up period, we evaluated the presence of malocclusion, chin deviation, trismus, pain, click sound, facial nerve palsy, hypertrophic scar and skin fistula.
RESULTS
According to the radiographic findings, the fractured condyle was reducted satisfactorily in all patients without any symptoms of facial palsy. During the follow up period ranged form 6 to 12 months, all clinical symptoms were improved except in one case with chin deviation and malocclusion.
CONCLUSION
Using open reduction and internal fixation of mandibular condyle fracture with retromandibular approach, all results were satisfactory with good functional outcomes and minimal complication. We concluded that the open surgical treatment should be considered as the first choice for mandibular condyle fracture management.

Keyword

Mandibular condyle; Fracture

MeSH Terms

Chin
Cicatrix, Hypertrophic
Ear
Facial Nerve
Facial Paralysis
Follow-Up Studies
Humans
Immobilization
Joints
Malocclusion
Mandibular Condyle
Paralysis
Skin
Trismus
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