Hung-Ying LIN
Division of Oral and Maxillofacial Surgery
National Taiwan University
Fracture
of mandibular condyle area are common and account for 9-45% of mall mandibular
fractures in adult. Due to the unique functional anatomy of mandibular condyle,
fracture and inadequate management may result in subsequent functional
impairment on occlusion, speech and mouth opening.
Therefore,
management for condylar fracture is still a difficult task for oro-maxillo-facial
surgeon.
Although
there are criteria for open reduction nowadays, such as bilateral fracture,
limitation on functional movement and severe jaw deviation, which caused inability
to bring the teeth into occlusion after closed reduction. Traditionally, surgical
approach for condylar fracture includes preauricular, retroauricular, transparotid,
retromandibular and submandibular approach. Either of which can obtained a clear
surgical field for anatomical reduction and fixation. But there still come
complications. With the concern of post-operative facial scar and risk of
facial nerve injury, most of patient wound like choose close reduction with
intermaxillary fixation for 1~2 weeks, instead of open reduction. But the
functional disturbance of trismus, or post-traumatic malocclusion due to change
of ramus height remain major issues thereafter.
With
the improvement on surgical technique, transoral approach with endoscope assist
may be a solution for this dilemma. It my honor to present a case series of condylar
fracture to share my experience. By discussion with all each other, the benefit,
risk and limitation of this technique can be clarify. I hope we can provide
more surgical options to patient and achieve a better treatment outcome
together.
