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CURRENT ISSUEITALIAN JOURNAL OF MAXILLOFACIAL SURGERY

A Journal on Maxillofacial Surgery

Official Journal of the Italian Society of Maxillofacial Surgery

Frequency: 3 issues

ISSN 1120-7558

Online ISSN 1827-1901

 

Rivista Italiana di Chirurgia Maxillo-Facciale 2002 April;13(1):9-14

    ORIGINAL ARTICLES

Retromandibular approach in subcondylar fractures. Report of 25 cases

Castellani A., Ferrari Parabita S., Zanetti U.

Maxillo-Facial Surgery Division, Civil Hospital, Brescia

Background. To ­present a ­report on 25 cas­es in ­which ­the ­short ret­ro­man­dib­u­lar ­approach ­was ­used to ­treat sub­con­dy­lar frac­tures. Advantages ­and lim­its of ­this tech­nique ­are eval­u­at­ed.
Methods. Twenty-­two ­patients (18 ­men, 4 wom­en) ­with dis­placed uni­lat­er­al (19 cas­es) or bilat­er­al (3 cas­es) con­dy­lar frac­ture, ­for a ­total of 25 frac­tures, ­were treat­ed ­through ­the ret­ro­man­dib­u­lar ­approach, ­under gen­er­al anaesthe­sia. The ­age of ­patients ­ranged ­from 18 to 57 ­years, ­with aver­age ­age of 23.8 ­years. The frac­tures treat­ed ­were in 8 cas­es locat­ed in ­the ­low cer­vi­cal ­area, in 17 cas­es ­they ­were locat­ed sub­con­dy­lar­ly. Postoperative com­pli­ca­tions ­were eval­u­at­ed on ­day 7 ­and 6 ­months ­after ­the oper­a­tion.
Results. Complications ­found on ­day 7: 2 tran­si­to­ry ­facial ­nerve dam­age, 2 post­op­er­a­tive hae­mat­o­ma. Follow-up at 6 ­months: com­plete res­to­ra­tion of ­nerve func­tion, in ­both cas­es; hae­mat­o­ma res­o­lu­tion with­out com­pli­ca­tions. In ­all cas­es ­observed ­the ­scars ­were lin­e­ar.
Conclusions. Retromandibular ­access is chief­ly indi­cat­ed ­for ­low sub­con­dy­lar frac­tures (ver­ti­cal ­ramus of ­the man­dible) ­since in ­these cas­es ­the ­bone frag­ments ­may eas­i­ly be ­exposed with­out ­the ­need to ­use exces­sive ­force in retract­ing ­the over­ly­ing tis­sue of ­the ­cheek.

language: English


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