[Fracture of the glenoid fossa without condylar dislocation and with intact mandibular condyle. Report of a case].
The osteomuscular structure of the cranium presents peculiar anatomic characteristics that aim to preserve the noble organs that are housed inside or are adjacent to them. This is also true of the condylar region which protects the cranial cavity from forces transmitted to the glenoid cavity by the condyle in traumatism to the facial region and above all the genial symphysis. These factors act as "force breakers" to prevent the condyle penetrating the middle cranial fossa. Of these the most important is the presence of a line of minor resistance at the level of the condyle neck which is often the site of a protective fracture. However, the dislocation of the condyle in the middle cranial fossa is an occurrence that is reported in the literature, albeit very rarely; the fracture of the glenoid fossa with an intact mandibular condyle and without evident dislocation of the latter is even more rare. The paper reports the case of a 22-year-old male patient who was injured in the submental area leading to loss of conscience. CT revealed that the left mandibular condyle was intact whereas there was a comminuted fracture of the roof of the glenoid fossa and two fractures at the mandibular level. The patient also presented left otoliquorrhea. The glenoid fracture was not complete and therefore the mandibular condyle did not show evident dislocation nor was it necessary to resort to surgical or non-surgical treatment. After the reduction and restraint of the two mandibular fractures, occlusion was correct and the position of the left condyle was appropriate following X-ray control, even if the glenoid cavity was partially fractured. Otoliquorrhea resolved spontaneously after about three days and did not require any treatment. The case described here, which was recontrolled after some time, presented excellent functional results demonstrating that conservative treatment of the glenoid cavity fracture was the correct therapeutic choice.
Benech
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A
Dipartimento di Fisiopatologia Clinica, Università degli Studi, Torino.
Gallesio
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C
De Gioanni
P P
PP
Fasciolo
A
A
D000328:Adult; D005592:Fracture Fixation; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries; D008337:Mandibular Fractures / Q000209:etiology* / Q000628:therapy; D013701:Temporal Bone / Q000293:injuries*; D013704:Temporomandibular Joint / Q000293:injuries*; D014057:Tomography, X-Ray Computed