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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2002 April;13(1):9-14
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.