Usefulness of the Retromandibular Transparotid Approach for Condylar Neck and Condylar Base Fractures
Usefulness of the Retromandibular Transparotid Approach for Condylar Neck and Condylar Base Fractures
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DOI：
10.1097/scs.0b013e31824dbb35
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发表时间：
2012-05-01
影响因子：
0.9
通讯作者：
Choi, Byung-Joon
中科院分区：
文献类型：
--
作者：
Kim, Bae-Kyung;Kwon, Yong-Dae;Choi, Byung-Joon
髁突骨折占所有下颌骨骨折的20%至30%，因此是最常见的面部骨折。骨折模式可以有很大的变化，可能发生在沿着从乙状切迹到下颌角的任何地方。主要的问题是进入，难以重新定位的极细长的碎片，和固定的contile.Eighty患者被诊断为髁状突颈部或髁状突基底骨折，从2007年1月至2009年12月在庆熙大学口腔颌面外科医院。在这项研究中，我们纳入了35例接受开放手术的患者和28例采用下颌后经腮腺入路治疗的患者，手术治疗的目的是解剖复位和刚性固定的碎片，咬合稳定，迅速恢复功能，保持垂直升支的尺寸，没有气道损害，并减少长期颞下颌关节功能障碍。鉴于髁状突骨折的发生率高，髁状突是下颌骨的重要生长中心，口外入路是治疗髁状突骨折的有效方法，具有入路短、复位容易、手术时间短、术后咬合稳定等优点。此外，没有永久性损害，面神经损伤，唾液泄漏，或耳前感觉减退。因此，对于根据斯特拉斯堡接骨术研究组分类的髁突颈或髁突基底骨折患者，下颌后经腮腺入路被认为是一种安全有效的方法，这些患者需要采用口外入路进行手术治疗。
Condyle fractures represent 20% to 30% of all mandibular fractures and are thus among the most common facial fractures. The fracture pattern can vary greatly and may occur anywhere along the line from the sigmoid notch to the mandibular angle. The main problems are access, difficulty in repositioning the extremely slender fragments, and fixation of the condyle.Eighty-seven patients were diagnosed with condylar neck or condylar base fractures from January 2007 to December 2009 in the Department of Oral & Maxillofacial Surgery of Kyung Hee University Dental Hospital. In this study, we included 35 patients who underwent open surgery and a total of 28 patients who were treated using a retromandibular transparotid approach.Surgical treatment aims were anatomic repositioning and rigid fixation of the fragments, occlusal stability, rapidly return to function, maintenance of vertical ramus dimension, no airway compromise, and reduced long-term temporomandibular joint dysfunction. Considering the high rate of occurrence of condylar fracture and the importance of the condylar as a growth center of the mandible, extraoral approaches for the open reduction of condylar fractures are considered effective and can be used widely.Short access route, easy reduction, short operating time, and stable postoperative occlusion are the advantages of the retromandibular transparotid approach. Also, there was no permanent damage from facial nerve injury, salivary leakage, or preauricular hypoesthesia. Therefore, the retromandibular transparotid approach is considered a safe and effective method for patients with a condylar neck or condylar base fracture classified according to the Strasbourg Osteosynthesis Research Group's classification, who require surgical treatment with an extraoral approach.