Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 7-8, Pages: 391-396
https://doi.org/10.2298/SARH1608391N
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Modified Risdon approach using periangular incision in surgical treatment of subcondylar mandibular fractures
Nikolić Živorad S. (Faculty of Dental Medicine, Clinic for Maxillofacial Surgery, Belgrade)
Jelovac Drago B. (Faculty of Dental Medicine, Clinic for Maxillofacial Surgery, Belgrade)
Šabani Melvil (Faculty of Dental Medicine, Clinic for Maxillofacial Surgery, Belgrade + Clinique de Genolier, Genolier, Switzerland)
Jeremić Jelena V. (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Burns, Plastic and Reconstructive Surgery, Belgrade)
Introduction. No consensus has been reached yet on the surgical approach for
treatment of condylar fractures. Objective. The aim of this study was to
present modified Risdon approach (without facial nerve identification) in the
treatment of subcondylar mandibular fractures. Method. This is a
retrospective study of a period 2005-2012. During this seven-year period, 25
condylar mandibular fractures in 22 men and three women (19-68 years old)
were treated by modified Risdon approach without identifying the facial
nerve. The main inclusion criterion was subcondylar fracture according to
Lindahl classification. Results. No additional morbidity related to
postoperative complications, such as infection or salivary fistula, was
observed in this series. Only two (8%) patients developed temporary weakness
of the marginal branch of the facial nerve, which resolved six weeks
postoperatively. Each patient achieved good mouth opening postoperatively.
Scar was camouflaged in the first cervical wrinkle. Two patients developed
temporomandibular joint dysfunction. No patient had postoperative occlusal
disturbance. In all of the patients good aesthetic result was achieved in a
two-year follow-up. Conclusion. In comparison with techniques described in
the literature, the main advantages of the modified Risdon approach are the
following: no need for facial vessels identification; direct, fast, and safe
approach to mandibular angle and subcondylar region; relatively simple
surgical technique and good cosmetic result - due to aesthetically placed
incision. This approach could be recommended for subcondylar fracture as a
simplified and safe procedure.
Keywords: subcondylar fracture, extraoral approach, open reduction
Projekat Ministarstva nauke Republike Srbije,
br. 175075