The 3rd Takao Forum of Oral and Maxillofacial Surgery
Prof. Takahiro Kanno, DDS, FIBCSOMS, FIBCSOMS-ONC/RECON, PhD
Department of Oral and Maxillofacial Surgery, Shimane University Faculty of
Medicine & Maxillofacial Trauma Center, Shimane University Hospital,
Izumo, Shimane, Japan
Title of Lecture②:
Trends of Surgical Approaches for Open Reduction and Internal Fixation of Mandibular Condyle Fracture
Abstract
Our maxillofacial injuries are commonly encountered in the daily practice and of
emergency medicine. Nearly 50% of such patients with these facial injuries have
multisystemic trauma that requires coordinated management between emergency
physicians and surgical specialists.
Of these, the mandibular condylar process is one of the most frequent sites of
mandibular fracture. Mandibular condylar fractures account for 18% - 52% of all
mandibular fractures as the most common fracture site of the mandible. Although
absolute and relative indications for surgical treatment of open reduction and
internal fixation (ORIF) have been proposed, and treatment choices in such patients
tend to be based on the surgeon’s experience and preferences. When mandibular
condylar fractures cause oromandibular dysfunction, surgical treatment of ORIF
may be needed for better occlusion and temporomandibular joint function because
accurate reduction and rigid fixation allow good anatomical repositioning and
immediate functional recovery. Recently, surgical treatment for condylar fractures
has become more and more the standard treatment option because of advancements
in technology, development of indigenous osteosynthesis devices, and
enhancement of surgical techniques and various feasible surgical approaches
introduced owing to a better understanding of surgical anatomy and
accumulated data may support these so far.
Several surgical approaches of intraoral (with or without endoscopic assistance)
and extraoral (Preauricular approach, Retromandibular approach, Submandibular
approach, High-submandibular approach) applicable for open treatment of ORIF of
mandibular condyle fractures, and have been used to expose, reduce, and stabilize
the fracture site, each with its own set of advantages and disadvantages. The
application of these various surgical approaches has been, however, all still
remaining controversial based on the surgeon’s experience and preferences.
