medigraphic.com
ISSN 2992-8559 (Electronic)
ISSN 1405-0625 (Print)

2003, Number 3

<< Back Next >>

Cir Plast 2003; 13 (3)

Endoscopy useful for treatment of fractures of the mandibular condyle and internal orbit

Cienfuegos-Monroy R, Sierra-Martínez E

Language: Spanish
References: 20
Page: 101-107
PDF size: 267.15 Kb.


ABSTRACT

Endoscopic techniques are a novel resource in the treatment of certain facial fractures. Ten patients, six with fractures of the mandibular condyle and four with fractures of the internal orbit, were operated on with endoscopy-assisted techniques. In condylar process fractures, an intraoral approach was used, with a preauricular accessory port. The internal orbit was repaired through a vestibular incision and an opening in the maxillary antrum in one case; a limited upper-blepharoplasty incision in two cases; and through the wound of an open fracture in one case, with an accessory port in the upper eyelid. Condylar process fractures were fixed with 2.0 titanium mandibular plates and screws. In the internal orbit fractures, the entrapped soft tissues were freed and repositioned, splinters were removed and the defect was repaired with titanium mesh. All patients had a favorable postoperative outcome. Condylar process fractures underwent union with no callus formation. There were no injuries to the facial nerve nor occlusal disturbances. In orbital fractures, normal eye movements and orbital volume were restored. We concluded that endoscopic treatment reduces the risk of injury to the facial nerve in condylar fractures, and enables the internal orbit repair without the need for wide surgical approaches, such as the coronal incision.


REFERENCES

  1. Hunter JG, Sackier JM. Minimally invasive high tech surgery: into the 21st century. In: Hunter JG, Sackier JM (eds.): Minimally invasive surgery. Nueva York: McGraw-Hill, Inc., 1993: 3-6.

  2. Carrasco-Rojas JA. Historia de la cirugía de invasión mínima. En: Heredia-Jarero, NM. Carrasco-Rojas JA. Shuchleib-Ch S. Chousleb-K A. Pérez-Castro VVJ. (Eds). Cirugía Endoscópica. Actualidades, Avances y Perspectivas. México: Intersistemas Editores. 2002: 1-8.

  3. Freeman MS. Endoscopic techniques for rejuvenation of the midface. Fac Plast Surg Clin N Am 2001; 9: 453.

  4. Namazie AR, Keller GS. Current practices in endoscopic brow and temporal lifting. Fac Plast Surg Clin N Am 2001; 9: 439.

  5. Shumrick KA, Ryzenman JM. Endoscopic management of facial fractures. Fac Plast Surg Clin N Am 2001; 9: 469.

  6. Lee C, Mankani MH, Kellman RM, Forrest CR. Minimally invasive approaches to mandibular fractures. Fac Plast Surg Clin N Am 2001; 9: 475.

  7. Schilli W, Stoll P, Bähr W, Prein J. Mandibular fractures. In: Prein J (ed.) Manual of Internal Fixation in the Cranio-Facial Skeleton. Berlín: Springer Verlag, 1998: 57-93.

  8. Hammer B. Diagnosis and classification. In: Hammer B. Orbital fractures. Diagnosis, operative treatment, secondary corrections. Göttingen: Hogrefe & Hoover Publishers, 1995: 7-17.

  9. Margulies DR, Shabot MM. Fiberoptic imaging and measurement. In: Hunter JG, Sackier JM (eds.): Minimally invasive surgery. Nueva York: McGraw-Hill, Inc., 1993: 7-14.

  10. Berci G. History of endoscopic surgery. In: Greene FL. Ponsky JL (eds.). Endoscopic surgery. Philadelphia: WB Saunders Company, 1994: 1-5.

  11. Jacobovicz J, Lee C, Trabulsy PP. Endoscopic repair of mandibular subcondylar fractures. Plast Rec Surg 1998; 101: 437-41.

  12. Lee C, Mueller RV, Lee K, Mathes SJ. Endoscopic subcondylar fracture repair: functional, aesthetic, and radiographic outcomes. Plast Rec Surg 1998; 102: 1434.

  13. Lauer G, Schmelzeisen R. Endoscope-assisted fixation of mandibular condylar process fractures. J Oral Maxillofac Surg 1999; 57: 36.

  14. Anastassov GE, Lee H, Schneider R. Arthroscopic reduction of a high condylar process fracture: a case report. J Oral Maxillofac Surg 2000; 58: 1048.

  15. Troulis MJ, Kaban LB. Endoscopic approach to the ramus/condyle unit: clinical applications. J Oral Maxillofac Surg 2001; 58: 503.

  16. Hammer B, Schier P, Prein J. Osteosynthesis of condylar neck fractures: a review of 30 patients. Br J Oral Maxillofac Surg 1997; 35: 288.

  17. Ellis E, Throckmorton GS, Palmieri C. Open treatment of condylar process fractures: assessment of adequacy of repositioning and maintenance of stability. J Oral Maxillofac Surg 2000; 58: 27.

  18. Ellis E, McFadden D, Simon P, Throckmorton G. Surgical complications with open treatment of mandibular condylar process fractures. J Oral Maxillofac Surg 2000; 58: 950.

  19. Moreno JC, Fernández A, Ortiz JA, Montalvo JJ. Complication rates associated with different treatments for mandibular fractures. J Oral Maxillofac Surg 2000; 58: 273.

  20. Schön R, Schramm, Gellrich N-C, Schmelzeisen R. Follow-up of condylar fractures of the mandible in 8 patients at 18 months after transoral endoscopic-assisted open treatment. J Oral Maxillofac Surg 2003; 61: 49.




2020     |     www.medigraphic.com