ENDOSCOPIC-ASSISTED OPEN REDUCTION AND INTERNAL FIXATION (EAORIF) FOR CONDYLAR FRACTURE

내시경을 이용한 하악골 과두경부 골절의 정복 및 견고 고정술

  • Paeng, Jun-Young (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Ok, Yong-Ju (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Myoung, Hoon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Hwang, Soon-Jung (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Seo, Byoung-Moo (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Choi, Jin-Young (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Lee, Jong-Ho (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Choung, Pill-Hoon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ;
  • Kim, Myung-Jin (Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University)
  • 팽준영 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 옥용주 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 명훈 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 황순정 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 서병무 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 최진영 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 이종호 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 정필훈 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 김명진 (서울대학교 치과대학 구강악안면외과학교실)
  • Published : 2006.10.30

Abstract

The endoscopic assisted approach for the treatment of condylar fracture is a less invasive alternative treatment modality and is considered to be able to overcome the limited access to the operation field to obtain an accurate reduction and fixation. Six patients with condylar neck and subcondylar fracture underwent the endoscopic assisted open reduction and internal fixation through the transoral approach at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The endoscope was inserted through an intraoral incision and the reduction of fracture fragment was performed via a transbuccal approach with two transcutaneous stab incisions. Five patients showed anatomic reduction without any complications. One patient, whose fracture site was fixed with a single plate, showed displacement of fractured condylar segment during the follow up period. No patient had any facial nerve damage.

Keywords

References

  1. Zide MF, Kent JN: Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg 1983;41:89-98 https://doi.org/10.1016/0278-2391(83)90214-8
  2. Ellis E3, Dean JP: Rigid fixation of mandibular condyle fractures. Oral Surg Oral Med Oral Pathol 1993;76:6-15 https://doi.org/10.1016/0030-4220(93)90285-C
  3. Koberg WR, Momma WG: Treatment of fractures of the articular process by functional stable osteosynthesis using miniaturized dynamic compression plates. Int J Oral Surg 1978;7:256-262 https://doi.org/10.1016/S0300-9785(78)80091-X
  4. 久保四郞, 村橋 頀, 福田 修, 橘 直哉: 顎關節突起骨折124症例に關する 臨床的檢討, 特にその分類について. 日口外會誌 1983;29:1794-1805
  5. Lindahl L: Condylar fractures of the mandible. I. Classification and relation to age, occlusion, and concomitant injuries of teeth and teethsupporting structures, and fractures of the mandibular body. Int J Oral Surg 1977;6:12-21 https://doi.org/10.1016/S0300-9785(77)80067-7
  6. Siverman SL: A new operation for displaced fractures of the neck of the mandibular condyle. Dent Cosmos 1925;67:876
  7. Petzel JR: Instrumentarium and technique for screw-pin-osteosynthesis of condylar fractures. J Maxillofac Surg 1982;10:8-13 https://doi.org/10.1016/S0301-0503(82)80004-0
  8. Brown AE, Obeid G: A simplified method for the internal fixation of fractures of the mandibular condyle. Br J Oral Maxillofac Surg 1984;22:145-150 https://doi.org/10.1016/0266-4356(84)90027-5
  9. Lee C, Mueller RV, Lee K, Mathes SJ: Endoscopic subcondylar fracture repair: functional, aesthetic, and radiographic outcomes. Plast Reconstr Surg 1998;102:1434-1443 https://doi.org/10.1097/00006534-199810000-00016
  10. Honda T, Nozaki M, Isono N, Sasaki K: Endoscope-assisted facial fracture repair. World J Surg 2001;25:1075-1083 https://doi.org/10.1007/s00268-001-0061-0
  11. Lauer G, Schmelzeisen R: Endoscope-assisted fixation of mandibular condylar process fractures. J Oral Maxillofac Surg 1999;57:36-39 https://doi.org/10.1016/S0278-2391(99)90629-8
  12. Chen CT, Lai JP, Tung TC, Chen YR: Endoscopically assisted mandibular subcondylar fracture repair 2. Plast Reconstr Surg 1999;103:60-65 https://doi.org/10.1097/00006534-199901000-00011
  13. Schon R, Gutwald R, Schramm A, Gellrich NC, Schmelzeisen R: Endoscopy-assisted open treatment of condylar fractures of the mandible: extraoral vs intraoral approach. Int J Oral Maxillofac Surg 2002;31:237-243 https://doi.org/10.1054/ijom.2001.0213
  14. Sandler NA, Andreasen KH, Johns FR: The use of endoscopy in the management of subcondylar fractures of the mandible: a cadaver study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:529-531 https://doi.org/10.1016/S1079-2104(99)70080-6
  15. Haug RH, Peterson GP, Goltz M: A biomechanical evaluation of mandibular condyle fracture plating techniques. J Oral Maxillofac Surg 2002;60:73 https://doi.org/10.1053/joms.2002.29078
  16. Choi BH, Yi CK, Yoo JH: Clinical evaluation of 3 types of plate osteosynthesis for fixation of condylar neck fractures. J Oral Maxillofac Surg 2001;59:734-737 https://doi.org/10.1053/joms.2001.24283
  17. Choi BH, Kim KN, Kim HJ, Kim MK: Evaluation of condylar neck fracture plating techniques. J Craniomaxillofac Surg 1999;27:109-112 https://doi.org/10.1016/S1010-5182(99)80023-7
  18. Troulis MJ, Kaban LB: Endoscopic approach to the ramus/condyle unit: Clinical applications. J Oral Maxillofac Surg 2001;59:503-509 https://doi.org/10.1053/joms.2001.22706
  19. Miloro M: Endoscopic-assisted repair of subcondylar fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:387-391 https://doi.org/10.1016/j.tripleo.2003.07.004
  20. Haug RH, Brandt MT: Traditional versus endoscope-assisted open reduction with rigid internal fixation (ORIF) of adult mandibular condyle fractures: a review of the literature regarding current thoughts on management. J Oral Maxillofac Surg 2004;62:1272-1279 https://doi.org/10.1016/j.joms.2004.04.017