Endoscopically-assisted transoral approach for the treatment of subcondylar fractures of the mandible.
BACKGROUND
Treatment of subcondylar fractures of the mandible is one of the most controversial aspects in the field of maxillofacial traumatology. This controversy centers on the positive and negative aspects of open and closed approaches for the treatment of this kind of fractures. Open techniques lead to good reduction and osteosynthesis, but have a high risk of injury to the facial nerve and produce facial scars. Closed techniques (intermaxillary fixation) reduce all the above-mentioned risks but rarely produce correct anatomic reduction, and complications such as ankylosis, condylar necrosis and inhibition of mandibular growth, causing abnormal occlusion, may occur. Despite all the associated risks, closed techniques are currently the most popular treatment.


OBJECTIVE
To introduce the endoscopically-assisted transoral approach for the treatment of subcondylar fractures, presenting three cases treated in our department. A description of the technique has been included as well as the clinical and radiographic results obtained.


METHODS
The study is based in three patients with subcondylar fractures of the mandible who were treated by an endoscopically-assisted transoral approach. A description of the surgical technique is included. The results were assessed by postsurgical radiographic control (orthopantomography), maximum mouth opening, occlusion and pain.


RESULTS
Three reductions of subcondylar fractures with transoral endoscopically-assisted approach were undertaken. The follow-up period was 6 months. Postsurgical radiographic control showed good reduction of the fracture in all three cases. None of the patients showed any sign of temporomandibular dysfunction after 6 months.


CONCLUSIONS
Endoscopic treatment by transoral approach combines the positive aspects of both conventional techniques: closed and open reduction; allowing anatomic reduction and a stable fixation leaving no visible facial scars and with a minimum risk of injury to the facial nerve.
Cho-Lee
Gui-Youn
GY
Oral and Maxillofacial Surgery, University Hospital La Princesa, Madrid, Spain. gui-youncho@hotmail.com
Rodríguez Campo
Francisco J
FJ
González García
Raúl
R
Muñoz Guerra
Mario F
MF
Sastre Pérez
Jesús
J
Naval Gías
Luis
L
D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery*; D008337:Mandibular Fractures / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods