POST OPERATIVE EVALUATION FOR RETROMANDIBULAR APPROACH OF SUBCONDYLAR FRACTURES

하악골 과두하 골절 시 후하악접근법 통해 ORIF 시행한 환자들의 술 후 추적조사

  • Lee, Seul-Ki (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym Univ. Medical center) ;
  • Song, Kyoung-Ho (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym Univ. Medical center) ;
  • Kim, Jwa-Young (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym Univ. Medical center) ;
  • Song, Sang-Hoon (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym Univ. Medical center) ;
  • Yang, Byoung-Eun (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym Univ. Medical center) ;
  • Choi, Won-Cheul (Department of Dentistry, College of Medicine, Chung-Ang Univ.) ;
  • Kim, Seong-Gon (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym Univ. Medical center)
  • 이슬기 (한림대학교 의과대학 한림대학교성심병원 구강악안면외과학교실) ;
  • 송경호 (한림대학교 의과대학 한림대학교성심병원 구강악안면외과학교실) ;
  • 김좌영 (한림대학교 의과대학 한림대학교성심병원 구강악안면외과학교실) ;
  • 송상훈 (한림대학교 의과대학 한림대학교성심병원 구강악안면외과학교실) ;
  • 양병은 (한림대학교 의과대학 한림대학교성심병원 구강악안면외과학교실) ;
  • 최원철 (중앙대학교 의과대학 치과학교실) ;
  • 김성곤 (한림대학교 의과대학 한림대학교성심병원 구강악안면외과학교실)
  • Published : 2007.12.31

Abstract

Purpose: The classic technique for open reduction of subcondylar fractures is the submandibular approach. The aim of this study was to evaluate clinical result of retromandibular approach to displaced subcondylar fractures. Material and methods: During a period of 24months we perfomed a prospective study with a retromandibular approach in 23 patients with displaced subcondylar fractures. In this article we describe clinical result in 23 patients with follow ups for 3 months after surgery. Preoperatively all patients had malocclusion and radiology demonstrated displacement. Result: The retromandibularl approach for ORIF was good in all case. Mouth opening(M/O) was 49mm. Occlusion was good too. Permanent facial nerve palsy was not detected. Conclusion: Our findings indicate that the retromandibular approach is a safe technique for subcondylar fractures.

Keywords

References

  1. Williams JL1. Rowe and Williams' Maxillofacial Injuries. 2nd Ed. Churchill Livingstone 1994:409
  2. Hidding J, Wolf R, Pingel D: Surgical versus nonsurgical treatment of the articular process of the mandible. J craniomaxillofac Surg 1992;20:345-7 https://doi.org/10.1016/S1010-5182(05)80363-4
  3. Chossegros et al.: Short retromandibular approach of subcondylar fractures. Oral Surg Oral Med Oral Patho Oral Radio Endod 1996;82;248-52 https://doi.org/10.1016/S1079-2104(96)80347-7
  4. Edward Ellis III, Michael F. Zide. 안면골에 대한 외과적 접근법. 서울: 상아출판사. 2001
  5. McArthur C, Donald P, Knowles J, Moore C: Open reduction fixation of mandibular subcondylar fractures. Arch Otolaryngol Head Neck Surg 1993;119:403-6 https://doi.org/10.1001/archotol.1993.01880160049008
  6. Ellis E, Dean J: Rigid fixation of mandibular condyle fractures. Oral Surg Oral Med Oral Patho 1993;76:6-15 https://doi.org/10.1016/0030-4220(93)90285-C
  7. Hinds EC, Girotti WJ: Vertical subcondylar osteotomy. a reappraidal Oral surg Oral Med Oral Patho 1967;24:164-70 https://doi.org/10.1016/0030-4220(67)90256-3
  8. Zide MF, Kent JN: Indications for open reduction of mandibular condyle freactures. J oral Maxillofac Surg 1983;41:89-93 https://doi.org/10.1016/0278-2391(83)90214-8
  9. Okeson: Mannagement of Temporomandibular Disorders and Occlusion. Mosby 1999
  10. 김명진, Medication & chemicals in Dentistry II , 서울: 의치학사, 2004
  11. Richard H. Haug, Leon A, Assael: Outcomes of Open Versus Closed Treatment of Mandibular Subcondylar Fractures. J Oral Maxillofac Surg 2001;59:370-375 https://doi.org/10.1053/joms.2001.21868
  12. C.A Landes, R. Lipphardt: Prospective evaluation of a pragmatic treatment rationale: open reduction and internal fixation of didplaced and dislocated condyle and condylar head fractures and closed reduction of non-displaced, non-dislocated fractures. Int J Oral Maxiilofac Surg 2005;34:859-870 https://doi.org/10.1016/j.ijom.2005.04.021
  13. Tasanen A, Lamberg MA: Transosseous wiring in the treatment of condylar fractures of the mandible. J Oral Maxillofac Surg 1976;4:200-211
  14. M. Manisali, M. Amin, B. Aghabeigi, L. Newman.: Retromandibular approach to the mandibular condyle: a clinical and cadaveric study. Int. J. Oral maxillofac Surg 2003;32:253-256 https://doi.org/10.1054/ijom.2002.0270
  15. 김명국: 머리 및 목 해부학. 4판. 서울:의치학사. 1999
  16. Dingman RO, Grabb WC: Surgical anatomy of the mandibular ramus of the facial nerve based on dissection of 100 facial halves. Plast Reconstr Surg 1962;29:266-272 https://doi.org/10.1097/00006534-196203000-00005
  17. Ziarah HA, Atkinson ME: The surgical anatomy of the cervical distribution of the facial nerve. Br J Oral Maxillofac Surg 1981;19:159 https://doi.org/10.1016/0007-117X(81)90001-9