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Retromandibular approach for the management of subcondylar fractures, followed by treatment of parotid gland fistulae: Case report

J Korean Dent Assoc > Volume 55(10); 2017 > Article
The Journal of The Korean Dental Association 2017;55(10):696-705.
Published online October 31, 2017.
하악 과두하 골절시 후하악 접근법에 의한 수술 후 발생한 이하선 누공 형성과 이에 대한 치료 증례
노재찬1, 김주원2, 양병은3
1한림대학교성심병원 구강악안면외과
2한림대학교의과대학 구강악안면외과
3한림대학교 임상치의학대학원
Retromandibular approach for the management of subcondylar fractures, followed by treatment of parotid gland fistulae: Case report
Jae-Chan Ro1, Ju-Won Kim2, Byoung-Eun Yang3
1Dept. of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital
2Dept. of Oral and Maxiilofacial Surgery, Hallym University College of Medicine
3Graduate School of Clinical Dentistry, Hallym University
Abstract
Condylar fractures account for one-third of all mandibular fractures. There are many surgical methods for the open reduction of condylar fractures, such as the transoral, submandibular, preauricular, and retromandibular approaches. Two patients suffering from condylar fractures, a 45-year-old man and a 25-year-old man, were admitted to our hospital. Both patients' condylar fractures were positioned too high for us to use the transoral approach. Therefore, we employed the retromandibular method to expedite the approach to the fracture site and minimize the size of the incision. After the surgical procedures in both cases, we experienced complications in the form of parotid gland fistulae, which rarely result from the retromandibular approach. A combination of botulinum toxin injection and amitriptyline medication was effective for the management of these parotid gland fistulae. Here, we report these two cases and offer a review of the literature on this article.
Key Words: Subcondylar fracture;Retromandibular approach;Parotid fistula;Botulinum toxin;Amitriptyline;


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