Comparative Evaluation of Modified Tragus Edge Approach and Retromandibular Approach to Mid- or Low-Level Mandibular Condylar Fractures
Tóm tắt
To compare and evaluate the modified tragus edge approach (MTEA) with retromandibular approach for surgical access to mid-level or low-level mandibular condylar fractures. This study comprised of 22 patients with mid-level or low-level condylar fracture. Patients with clinical and radiological evidence of mid-level or low-level condylar fracture are included only in this study. Patients were randomly divided into two groups: group A includes 11 patients, in which modified tragus edge approach was used, and group B includes 11 patients treated with retromandibular approach. Patients were evaluated clinically after first week, second week, fourth week, third month, and sixth month radiographically. The mean age of the study subjects in group A was 32.45 ± 8.98 years, while in group B, the mean age was 26.91 ± 5.79 years. Post-operatively, no significant difference was seen in relation to pain, occlusal relationship, mouth opening, and deviation of jaw during opening and closing movements. In terms of post-operative complication, only significant difference found between two groups is post-operative scar visibility, which is higher in retromandibular incision group as compared to MTEA. Thus, we can conclude that MTEA provides ease of operation as a good exposure of mandibular mid- or low-level condylar fracture as retromandibular approach but with less visibility of post-operative scar as compared to retromandibular approach.
Tài liệu tham khảo
Li Z, Zhao W, Liu C, Liu J (2016) Modified tragus edge approach for mid-level or low condylar fractures. Int J Oral Maxillofac Surg 45(9):1100–1103
Lechler C, Probst F, Cornelius C, Smolka W (2018) Open reduction and internal fixation of mandibular condylar base and neck fractures using strut plates. J Oral Maxillofac Surg 76(7):1494–1503
Rozeboom A, Dubois L, Bos R, Spijker R, de Lange J (2017) Closed treatment of unilateral mandibular condyle fractures in adults: a systematic review. Int J Oral Maxillofac Surg 46(4):456–464
Niezen E, Stuive I, Post W, Bos R, Dijkstra P (2015) Recovery of mouth-opening after closed treatment of a fracture of the mandibular condyle: a longitudinal study. Br J Oral Maxillofac Surg 53(2):170–175
Kanno T, Sukegawa S, Tatsumi H, Nariai Y, Ishibashi H, Furuki Y et al (2014) The retromandibular transparotid approach for reduction and rigid internal fixation using two locking miniplates in mandibular condylar neck fractures. Int J Oral Maxillofac Surg 43(2):177–184
Hou J, Chen L, Wang T, Jing W, Tang W, Long J et al (2014) A new surgical approach to treat medial or low condylar fractures: the minor parotid anterior approach. Oral Surg Oral Med Oral Pathol Oral Radiol 117(3):283–288
Colletti G, Battista V, Allevi F, Giovanditto F, Rabbiosi D, Biglioli F (2014) Extraoral approach to mandibular condylar fractures: our experience with 100 cases. J Craniomaxillofac Surg 42(5):e186–e194
Handschel J, Rüggeberg T, Depprich R, Schwarz F, Meyer U, Kübler N et al (2012) Comparison of various approaches for the treatment of fractures of the mandibular condylar process. J Craniomaxillofac Surg 40(8):e397–e401
Girotto R, Mancini P, Balercia P (2012) The retromandibular transparotid approach: our clinical experience. J Craniomaxillofac Surg 40(1):78–81
Zhou J, Ren C (2013) A preauricular long-corniform approach for open reduction and internal fixation of mandibular condylar fractures. J Craniomaxillofac Surg 41(5):359–366
Ebenezer V, Ramalingam B (2011) Comparison of approaches for the rigid fixation of sub-condylar fractures. J Maxillofac Oral Surg 10(1):38–44
Dahlström L, Kahnberg K, Lindahl L (1989) 15 years follow-up on condylar fractures. Int J Oral Maxillofac Surg 18(1):18–23
Zide MF, Kent JN (1983) Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg 41:89–98
Schneider M, Erasmus F, Gerlach K, Kuhlisch E, Loukota R, Rasse M et al (2008) Open reduction and internal fixation versus closed treatment and mandibulomaxillary fixation of fractures of the mandibular condylar process: a randomized, prospective, multicenter study with special evaluation of fracture level. J Oral Maxillofac Surg 66(12):2537–2544
Ellis E, McFadden D, Simon P, Throckmorton G (2000) Surgical complications with open treatment of mandibular condylar process fractures. J Oral Maxillofac Surg 58(9):950–958
Kshirsagar R, Singh V, Pawar S, Shah R (2015) Retromandibular approach in the management of condylar fractures by open reduction and internal fixation a prospective study. Natl J Maxillofac Surg 6(2):180
Eckelt U, Schneider M, Erasmus F, Gerlach K, Kuhlisch E, Loukota R et al (2006) Open versus closed treatment of fractures of the mandibular condylar process—a prospective randomized multi-centre study. J Craniomaxillofac Surg 34(5):306–314
Worsaae N, Thorn JJ (1994) Surgical versus nonsurgical treatment of unilateral dislocated low subcondylar fractures: a clinical study of 52 cases. J Oral Maxillofac Surg 52(4):353–360
Chossegros C, Cheynet F, Blanc J-L, Bourezak Z (1996) Short retromandibular approach of subcondylar fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 82(3):248–252
Biglioli F, Colletti G (2009) Transmasseter approach to condylar fractures by mini-retromandibular access. J Oral Maxillofac Surg 67(11):2418–2424