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Experience in the management of subcondylar fracture via a modified extraoral approach

Keywords: mandible , condyle , maxillofacial procedure

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Abstract:

A modified surgical approach to the mandibular condyle without the usual surgical complications is presented.Patients and Methods: This prospective study was conducted from December 2007 to April 2010, in the Department of Maxillofacial Surgery of Al-Noor Specialist Hospital, Makkah, Saudi Arabia. Forty patients with 47 subcondylar fractures were treated. The fractures were surgically treated via a modified extraoral approach with a pre-auricular incision extending to the retromandibular area; access to the condyle was obtained through a cleavage plane between parotid gland and masseter muscle. Patients were carefully followed up and evaluated at first post operative day, one week, one month, three months and six months postoperatively.Results: Our surgical approach provided a safe and fast access to the condylar fracture. Facial nerve examination showed no temporary or permanent injuries. No case of wound infection was found within 6-months follow up. Three (7.5%) patients developed a sialocele and a salivary fistula has been noticed in one case. Satisfactory occlusion was achieved and appropriate mandibular opening was found. Immediate postoperative radiographs revealed anatomic bone reduction.Conclusion: The applied surgical approach had satisfactory results in cases of condylar fractures.

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