Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1603457
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Endoscopic-Assisted Intraoral Open Reduction Internal Fixation of Mandibular Subcondylar Fractures: Initial Experiences from a Tertiary-Care Maxillofacial Center in India

Venkatesh Anehosur1, Abhijit Joshi1, Saravanan Rajendiran2
  • 1SDM Craniofacial Unit, SDM College of Dental Sciences and Hospital, Dharwad, Karnataka, India
  • 2Department of Dentistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India
Further Information

Publication History

24 December 2016

18 February 2017

Publication Date:
12 June 2017 (eFirst)

Abstract

Management of condylar fractures is a highly controversial and debatable area. Open reduction and internal fixation (ORIF) using an extraoral approach has certain benefits over the nonsurgical treatment. Risk of damage to the facial nerve and an extraoral scar remains constant deterrents. An endoscopic-assisted ORIF offers an intraoral approach, thus eliminating consequences such as scarring. Though this technique offers unparalleled advantages, it is associated with a steep learning curve. Surgical results improve only with patience and experience. Patients with condylar fractures reported to SDM Craniofacial Unit, Dharwad, India, from 2013 to 2015 are included. Patients were treated with endoscopic-assisted ORIF and were evaluated for functional outcomes that included occlusion, maximal interincisal opening, and deviation of mouth and complications such as facial nerve pareses, postsurgical infection, and morbidity. Fifteen patients included in the study: 4 left sided and 11 right sided fractures. Nine patients had associated other mandibular fracture. Mean age of the patients was 28.2 years. Mean mouth opening at the end of 1 week, 6 weeks, and 6 months was 32.6, 37.8, and 40.5 mm, respectively. Transient facial nerve pareses were noted in one patient, and an extraoral draining sinus was noted in another. Endoscopic-assisted ORIF has a definite scope in management of condylar fractures. Results are more predictable with appropriate case selection due to a steep learning curve and intraoperative technical challenges. An initial experience in ORIF using extraoral approaches would greatly benefit a surgeon in utilizing this novel and alternate tool.

Declaration

Ethical approval was given by SDMCDS, reference number: SDMCDS/IRB 2014/OS/02. Written patient consent has been obtained to publish clinical photographs. All authors have viewed and agreed to the submission.