Header

UZH-Logo

Maintenance Infos

Outcome of surgically treated fractures of the condylar process by an endoscopic assisted transoral approach


Blumer, Michael; Guggenbühl, Tobias; Wagner, Maximilian E H; Rostetter, Claudio; Rücker, Martin; Gander, Thomas (2019). Outcome of surgically treated fractures of the condylar process by an endoscopic assisted transoral approach. Journal of Oral and Maxillofacial Surgery, 77(1):133.e1-133.e9.

Abstract

Purpose Fractures of the condylar process are frequent. Ideal management of these fractures, as discussed in the literature, is controversial. Some recent meta-analyses have favored open reduction and internal fixation using various approaches. A strictly transoral approach has been described to minimize scarring and risk of facial nerve injury but has restricted visibility. This retrospective study analyzed outcomes of patients with unilateral mandibular condyle fractures who were treated by open reduction and internal fixation through an endoscopic-assisted transoral approach. Materials and Methods This study included 40 patients who were operated on from January 2015 through December 2016. All patients underwent surgery for a condylar process fracture using an endoscopic-assisted transoral approach. Fracture classification, demographic, and outcome data were collected. Results Most condylar process fractures were caused by falls from a height less than 3 m. Most were condylar base fractures and classified according to Spiessl and Schroll as Classes I and II. Sixteen patients showed a preoperative malocclusion, whereas 2 patients showed a slight postoperative malocclusion. In cases in which only 1 plate could be placed, the proximal fragment was shorter. A higher Spiessl and Schroll class showed a tendency toward longer operation times. For postoperative outcomes, 1 case of temporary facial palsy was the worst complication (2.5%), 2 cases exhibited minimal occlusal interference (5%), and 1 case exhibited a deviated mouth opening (2.5%). Ramus height was restored in all cases. No chronic pain was found in any cases.

Abstract

Purpose Fractures of the condylar process are frequent. Ideal management of these fractures, as discussed in the literature, is controversial. Some recent meta-analyses have favored open reduction and internal fixation using various approaches. A strictly transoral approach has been described to minimize scarring and risk of facial nerve injury but has restricted visibility. This retrospective study analyzed outcomes of patients with unilateral mandibular condyle fractures who were treated by open reduction and internal fixation through an endoscopic-assisted transoral approach. Materials and Methods This study included 40 patients who were operated on from January 2015 through December 2016. All patients underwent surgery for a condylar process fracture using an endoscopic-assisted transoral approach. Fracture classification, demographic, and outcome data were collected. Results Most condylar process fractures were caused by falls from a height less than 3 m. Most were condylar base fractures and classified according to Spiessl and Schroll as Classes I and II. Sixteen patients showed a preoperative malocclusion, whereas 2 patients showed a slight postoperative malocclusion. In cases in which only 1 plate could be placed, the proximal fragment was shorter. A higher Spiessl and Schroll class showed a tendency toward longer operation times. For postoperative outcomes, 1 case of temporary facial palsy was the worst complication (2.5%), 2 cases exhibited minimal occlusal interference (5%), and 1 case exhibited a deviated mouth opening (2.5%). Ramus height was restored in all cases. No chronic pain was found in any cases.

Statistics

Citations

Dimensions.ai Metrics
3 citations in Web of Science®
5 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

16 downloads since deposited on 19 Sep 2018
14 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic of Cranio-Maxillofacial Surgery
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Surgery
Health Sciences > Oral Surgery
Health Sciences > Otorhinolaryngology
Language:English
Date:1 January 2019
Deposited On:19 Sep 2018 13:50
Last Modified:29 Jul 2020 07:42
Publisher:Elsevier
ISSN:0278-2391
OA Status:Hybrid
Publisher DOI:https://doi.org/10.1016/j.joms.2018.08.013

Download

Hybrid Open Access

Download PDF  'Outcome of surgically treated fractures of the condylar process by an endoscopic assisted transoral approach'.
Preview
Content: Accepted Version
Filetype: PDF
Size: 3MB
View at publisher
Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)