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Closed vs Open vs Endoscopic Approach

Arch Otolaryngol Head Neck Surg. 2004;130:1228-1230.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Hypothesis:

Closed reduction with rigid and/or elastic maxillomandibular fixation provides results as good as open techniques in the management of subcondylar mandibular fractures.

Figure appears in full text version. Emre Vural, MD

BACKGROUND

Subcondylar mandibular fractures differ from the fractures located more distally in the mandible for 2 main reasons. First, these fractures are in close proximity to the temporomandibular joint, which is probably the most important structure for maintaining a normal chewing function. Alterations in the anatomic relationship and subsequently the function of this portion of the mandible may significantly change occlusion and range of motion. Second, surgical exposure and placing hardware for rigid internal fixation in this region is technically not as easy as in other locations, ie, the symphyseal and parasymphyseal body and even the angle and low ramus regions. By definition, subcondylar fractures refer to fractures located below the deepest portion of the sigmoid notch and their management is probably the most controversial.

In . . . [Full Text of this Article]

PROS AND CONS

Occlusion

Mastication

Range of Motion

Anatomic Reduction and Posterior Mandibular Height

Pain

Scarring

Nerve Dysfunction

Endoscopic Open Reduction and Internal Fixation

BOTTOM LINE

Emre Vural, MD
From the Division of Otolaryngology–Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock.

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