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Comparison of the clinical results between endoscopically assisted transoral approach and retromandibular approach for surgical treatment of mandibular subcondyle fracture

J Korean Dent Assoc > Volume 54(12); 2016 > Article
The Journal of The Korean Dental Association 2016;54(12):1045-1054.
Published online December 31, 2016.
Comparison of the clinical results between endoscopically assisted transoral approach and retromandibular approach for surgical treatment of mandibular subcondyle fracture
Woo-Yul Lee1, Jin-Yong Cho2, Sung-Won Yang3
1Dept. of oral and maxillofacial surgery, Gachon university Gil medical center
2Dept. of oral and maxillofacial surgery, Gachon university Gil medical center
3Dept. of oral and maxillofacial surgery, Gachon university Gil medical center
Abstract
Purpose
: Aim of this study is to describe and compare clinical results and complications epending on the surgical approaches for the mandibular subcondyle fracture Materials and methods : The patients who had been diagnosed as the mandibular subcondyle fracture and underwent open reduction and internal fixation from May 2009 to December 2014 were included. They were divided into two groups depending on the surgical approaches; endoscopically assisted transoral approach and retromandibular approach. Association between the preoperative fracture classification and post-operative results was reviewed depending on the surgical approaches. Results : The number of patients selected in this study was 33. Eighteen patients (male 7, female 11) underwent open reduction and internal fixation via retromandibular approach and fifteen patients (male 12, female 3) underwent open reduction and internal fixation via endoscopically assisted transoral approach. The mean age, follow up period, and operation time were 44.29pm15.19years, 9.97pm7.82months, and 161pm89.44minutes. Post-operative results were all "good" state in the retromandibular approach group regardless of the fracture classification but two patients in the endoscopically assisted transoral approach group underwent re-operation due to "poor" results. The fracture types of two were classified as displacement and lateral override at the same time. There was no statistically significant difference between two groups. Three patients in the retromandibular approach group had experienced facial nerve palsy (17%) temporarily. No one showed malocclusion in this study. There was no significant difference on the complications such as temporomandibular disorder, local infection, and condyle resorption depending on the surgical approaches. Conclusion : In this study, there was no significant difference on the complications between the two groups but retromandibular approach has advantage over endoscopically assisted transoral approach in case of the severely displaced subcondyle fracture.
Key Words: Mandibular fracture;Surgical approach;Complication;


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