The retromandibular transparotid approach enables the most direct access to the central and posterior part of the mandibular ramus including the condylar region. So far it has not been widely used for the management of benign pathology of the mandible. The purpose of this study was to evaluate the utilization rate of this approach in the nontrauma setting including the determination of suitable indications for this access. In total, 105 patients with 107 retromandibular transparotid approaches performed in the 6.5 years (from May 2014 to November 2020) were evaluated. Patients suffering from nontrauma pathology accounted for 4.7% of all cases. The recurrences of different types of odontogenic cysts and secondary chronic osteomyelitis were surgically managed via this approach with aesthetically acceptable resultant scar achievement and no identified postoperative complications. All lesions resolved and no recurrences occurred during the follow-up 32.0 ± 20.7 months (range 6 to 59 months, median = 26 months). The retromandibular transparotid approach may be considered for the enucleation of benign bone lesions in selected patients. Another type of surgery for the management of benign nontraumatic conditions in an accessible area without requirements for continuity resection and jaw reconstruction may be also suitable for using this approach.
Iatrogenic mandible fracture is a rare complication of a tooth extraction with an incidence between 0.0033-0.0034%. This study retrospectively analyzes a total of 8 patients who underwent lower molar extraction associated with mandible fracture during tooth removal in the period from April 2006 to March 2019. The assessed parameters were age and sex of patients, method of tooth extraction, side distribution of fracture, type of extracted tooth, the position of a lower third molar, presence of bone pathological lesion formed in connection with a tooth, displacement of bone fragments, and sensory impairment in the innervation area of the mental nerve. The position and impaction of the lower third molars were evaluated according to Pell and Gregory's classification and Winter's classification. One fracture was left-sided, and 7 fractures were right-sided. In 6 cases, Winter's extraction elevator was used. In 7 patients, the mandible fracture was treated surgically by performing stable osteosynthesis with the plates and screws. One patient was treated conservatively. This work analyzes the causes of iatrogenic mandible fractures and provides recommendations to reduce the risk of their occurrence.
- Klíčová slova
- Iatrogenic fracture, complications, dental elevator, lower jaw, tooth extraction,
- MeSH
- extrakce zubů škodlivé účinky MeSH
- fraktury mandibuly etiologie terapie MeSH
- iatrogenní nemoci MeSH
- lidé MeSH
- molár třetí chirurgie MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- chirurgie s pomocí počítače přístrojové vybavení metody MeSH
- dospělí MeSH
- fibula krevní zásobení transplantace MeSH
- fraktury mandibuly diagnostické zobrazování etiologie chirurgie MeSH
- kostní destičky MeSH
- lidé MeSH
- mandibula krevní zásobení diagnostické zobrazování chirurgie MeSH
- počítačová simulace MeSH
- počítačové modelování podle konkrétního pacienta MeSH
- rekonstrukce mandibuly metody MeSH
- reoperace MeSH
- volné tkáňové laloky krevní zásobení MeSH
- zobrazování trojrozměrné MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- dopisy MeSH
- kazuistiky MeSH
- publikace stažené z tisku MeSH
Sub-condylar fractures of the temporomandibular joint can be treated by an extraoral or intraoral approach. Trans-masseteric antero-parotid approach (TMAP) is an extraoral approach utilising a retromandibular incision. The authors evaluated patients' status and any complications of using TMAP from the years 2013-2017. There were 39 patients (44 fractures). When using TMAP, in 43 fractures the fragments were favourably positioned, in one case the position was compromised. Of the complications, postoperative palsy of the facial nerve was reported 6.8% - in all cases this was only temporary. Late occlusion had an equal number of complications (in 2 cases this was as a result of an infectious complication of the wound, and in 2 cases due to resorption of the proximal fragment). Muscular pain and dysfunction of the temporomandibular joint following trauma were observed consistently in 6.8% of patients. Sialocoele, a non-conforming scar, and infectious complications were observed in 4.5% of patients. TMAP allows rapid surgical performance, with a good view for perfect repositioning and fixation of fragments of sub-condylar fractures of the temporomandibular joint. The complications associated with this approach are, for the most part, temporary, the aesthetic handicap of a scar is considered by patients to be acceptable. Overall, it is possible to evaluate retromandibular TMAP as safe, and the authors recommended it for treatment of sub-condylar fractures of the mandible.
- Klíčová slova
- Mandible, Sub-condylar fractures, Trans-masseteric antero-parotid approach,
- MeSH
- fraktury mandibuly komplikace chirurgie MeSH
- lidé MeSH
- musculus masseter * chirurgie MeSH
- parotis * chirurgie MeSH
- pooperační komplikace * MeSH
- processus condylaris mandibulae chirurgie MeSH
- retrospektivní studie MeSH
- temporomandibulární kloub chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: The purpose of this preliminary study was to evaluate intraarticular soft tissues of the temporomandibular joint (TMJ) using intraoperative arthroscopy during open reduction and internal fixation (ORIF) of condylar head fractures (CHF). MATERIALS AND METHODS: 26 patients (29 joints) were diagnosed in period of 5 years (2011-2015) with CHF, 5 patients had concomitant mandibular fracture. Fractures were diagnosed on basis of conventional orthopantomogram (OPG) and computed tomography (CT). RESULTS: Intraoperative arthroscopy revealed hyperemia and hypervascularity in all 29 joints, anterior disc dislocation in 26 joints, cartilage erosion in 21 joints and hemorrhagic clots were present in 10 joints. Major hemarthrosis or tear of the posterior band, as often described in MRI, could not be shown in our patients. Data from the study further the understanding of intraarticular pathology of the TMJ after acute trauma in a group with CHF. CONCLUSION: Intraoperative arthroscopy is useful for direct evaluation and accurate diagnosis of the extent of soft tissue damage to TMJ in CHF. Larger and more long-term studies including comparison to MRI findings should be helpful to refine the treatment and postoperative management of patients after CHF.
- Klíčová slova
- Condylar head fracture, Disc displacement, Intraoperative arthroscopy, MRI assessment, Soft tissue injury,
- MeSH
- artroskopie * MeSH
- dospělí MeSH
- fraktury mandibuly diagnostické zobrazování chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- peroperační komplikace diagnostické zobrazování MeSH
- počítačová rentgenová tomografie MeSH
- processus condylaris mandibulae diagnostické zobrazování chirurgie MeSH
- rentgendiagnostika panoramatická MeSH
- retrospektivní studie MeSH
- vnitřní fixace fraktury metody MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The authors present their experience with endoscopy assisted open reduction and internal fixation of condylar fractures of the mandible. Their results are presented in a retrospective study of 33 patients with unilateral subcondylar fracture, who underwent a surgical procedure between 2010 and 2015. Reduction and fixation, stability of occlusion 12 months after the operation and also presence of complications were evaluated. RESULTS: Satisfactory reduction (anatomic or physiologic) was achieved in 31 patients. Stability of occlusion was worse in 1 patient (due to condylar absorption). Complications included mainly inflammatory complications (4 patients) and temporary paresis of the facial nerve (3 patients). Impaired function of temporomandibular joint was not reported in any of the patients. CONCLUSION: Endoscopy assisted open reduction and internal fixation is an alternative to classical surgical procedures, however it requires special instrumentarium and experienced surgical team.
- Klíčová slova
- Endoscopy, condyle complications., mandibular fracture,
- MeSH
- časové faktory MeSH
- dospělí MeSH
- endoskopie * MeSH
- fraktury mandibuly chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- otevřená repozice fraktury * MeSH
- pooperační komplikace diagnóza MeSH
- processus condylaris mandibulae zranění chirurgie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- vnitřní fixace fraktury * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The author proceeds with his earlier 1990 contribution ou the complementary examination of the skull of the Czech king and Roman emperor Charles IV. Direct relationship between the injury to the cervical spine and the newly detected healed fractures of the mandible was established. A strong blow on the king's chin induced the four-fold dislocated fracture of the mandible. Based on our present knowledge of medieval medicine, and especially facial traumatology an attempt was made to clarify the treatment methods applied in management of the king's injury.
- MeSH
- dějiny středověku MeSH
- fraktury mandibuly dějiny chirurgie MeSH
- fraktury páteře dějiny chirurgie MeSH
- krční obratle zranění MeSH
- lidé MeSH
- rány a poranění dějiny chirurgie MeSH
- významné osobnosti * MeSH
- Check Tag
- dějiny středověku MeSH
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- biografie MeSH
- časopisecké články MeSH
- historické články MeSH
- Geografické názvy
- Česká republika MeSH
- O autorovi
- Charles, I V
X-ray films of the skull of the king and emperor Charles IV and his four wives and two sons were made under standard conditions with the mandibles fixed in a centric occlusion. The results of roentgenocephalometric analysis were compared with norms valid for the contemporary Czech population. Consistent with the somatic condition of Charles IV, the findings indicate an above-average large face with the usual anteriorotational developmental type. The facial skeleton is structurally harmonious, but the sagittal intermaxillary relations belong into skeletal class II with a relatively retruded lower jaw in relation to the upper one. This is associated with a greater maxillary overjet of the upper incisors. The disharmony was caused by a fracture of the mandibular condyles. Reconstruction of the condition before the injury revealed an originally normal anteroposterior relationship of the jaws (skeletal class I) and occlusion of the incisors. As to the shape of the cranium, Charles IV's wives differ in basic features. In two, for different reasons, we find skeletal class II (retrogenia), in one skeletal class III (progenia) and only in Elizabeth of Pomerania, with marked flattening of the cranial base and posteriorotation of the face are the anteroposterior relations of the two jaws normal (skeletal class I). Wenceslas IV differs from his parents Charles IV and Anne of Svidnic by a flat cranial base which pushes the lower jaw backwards, however, it does not cause its posteriorotation; we find, similarly as in the father and mother, an anteriorotational growth type of the face. In the other basic parameters of the cranium there are no marked differences between son and parents. In evaluating the similarity of the facial structure of John of Görlitz to that of his parents, disagreement is caused by the flat cranial base of the mother Elizabeth of Pomerania associated with posteriorotation of the face. In the son we find, conversely, an even more marked anteriorotation than in the father and also other parameters of the facial configuration indicating plausible agreement with the findings in Charles IV. The curving of the cranial base has an impact on the shape of the whole cranium, but the results indicate that the heritability of the rotational growth type of face and the degree of cranial base curvature probably is not very marked.
- MeSH
- dějiny středověku MeSH
- fraktury mandibuly dějiny MeSH
- kefalometrie * MeSH
- lebka anatomie a histologie MeSH
- lidé MeSH
- malokluze - Angleova II. třída dějiny MeSH
- malokluze - Angleova III. třída dějiny MeSH
- maxilofaciální vývoj genetika MeSH
- processus condylaris mandibulae zranění MeSH
- retrognacie dějiny MeSH
- rodokmen MeSH
- rotace MeSH
- významné osobnosti * MeSH
- Check Tag
- dějiny středověku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- biografie MeSH
- časopisecké články MeSH
- historické články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
- O autorovi
- Luxemburg family
- MeSH
- dějiny středověku MeSH
- fraktury mandibuly dějiny MeSH
- lidé MeSH
- processus condylaris mandibulae zranění MeSH
- významné osobnosti * MeSH
- Check Tag
- dějiny středověku MeSH
- lidé MeSH
- Publikační typ
- biografie MeSH
- časopisecké články MeSH
- historické články MeSH
- Geografické názvy
- Československo MeSH
- O autorovi
- Charles, I V
The author's own method, making it possible to shorten substantially intermaxillary fixation while preserving all its principal advantages, was used to treat 252 patients with fractures of the dentulous mandible. After two weeks' intermaxillary fixation 134 fractures of the mandibular body and angle were fixed with a combination of Sauer's and occlusal splints, lingual splints or periangular wires according to Petz. This method shortened the treatment of the selected group of patients by the mean one week.
- MeSH
- dlahy MeSH
- dospělí MeSH
- fixace fraktur metody MeSH
- fraktury mandibuly diagnostické zobrazování terapie MeSH
- lidé MeSH
- mladiství MeSH
- rentgendiagnostika MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- časopisecké články MeSH
