Mandibular subluxation for distal internal carotid artery exposure in edentulous patients.
Four patients with high internal carotid artery (ICA) occlusive disease were indicated for surgical endarterectomy and needed additional exposure besides regular head rotation and extension. When indicated, in our clinic this is usually achieved by mandibular subluxation with interdental wiring. Due to dental wear and periodontal disease, all 4 patients were edentulous. As a consequence, the technique of interdental wiring could not be used. In this technical note we will explain a method for interarch fixation with the use of two ipsilateral monocortical miniscrews and wiring, and the use of patients' pre-existing mandibular implants and provisional overdenture. This method gives rise to an additional exposure of 15 to 20 mm of the ICA.
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Gijs W
GW
Jaspers
Max J
MJ
Witjes
Jan J
JJ
van den Dungen
Harry
H
Reintsema
Clark J
CJ
Zeebregts
D000368:Aged; D001863:Bone Screws; D001864:Bone Wires; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D007575:Jaw, Edentulous / Q000150:complications / Q000601:surgery*; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000295:instrumentation