A Clinical Analysis of the Usefulness of the High Perimandibular Approach Compared to the Risdon Approach in Mandibular Condyle Fracture: Single-institution Outcomes

DOI
  • HAMA Shion
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • MARUSE Yasuyuki
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University Japanese Red Cross Fukuoka Hospital, Dentistry and Oral Surgery
  • MORIYAMA Masafumi
    Section of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • KANEKO Naoki
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University OBT Research Center, Faculty of Dental Science, Kyushu University
  • NAKAMURA Seiji
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University
  • KAWANO Shintaro
    Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University

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Other Title
  • 下顎骨関節突起骨折におけるRisdon approachと比較したhigh perimandibular approachの有用性の検討

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In recent years, various surgical procedures have been reported for the open reduction and internal fixation （ORIF） of mandibular condyle fracture. In our department, the Risdon approach （RA） had been used for the ORIF of mandibular condyle fracture in the past, but since 2019, the high perimandibular approach （HPA） has been adopted. In this study, to clarify the differences between RA and HPA in mandibular condyle fracture, we compared the fracture site, operative time, postoperative facial nerve palsy, postoperative fixation, and amount of opening at discharge and at the end of opening training of these two techniques. Ninety cases and 105 sides with mandibular condyle fracture were diagnosed at our department during the ten years from 2013 to 2022. Twenty-two cases and 22 sides with ORIF were divided into the following two groups: RA group （11 cases and 11 sides） and HPA group （11 cases and 11 sides）, and then examined retrospectively. The operating time of the HA group （median time: 55 min） was significantly shorter than that of the RA group （median time: 89 min） （P＜0.01）. Postoperative facial paralysis was observed in 8 of 11 patients （72.7％） in the RA group only. No postoperative occlusal dysfunction or oral opening disorder was observed in either group. The results suggest that HPA is a useful technique that causes less postoperative paralysis in the mandibular marginal branch of the facial nerve and shorter operative time than RA.

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