Endoscopic-assisted approach for subcondylar fracture management

Cheng-Hsien WU

 

Oral & Maxillofacial Surgery, Taipei Veterans General Hospital

School of Dentistry, National Yang-Ming University

Abstract

The condylar region is one of the most frequent mandibular fracture sites, accounting for 9% to 45% of all mandibular fractures. Management of condylar/subcondylar fractures (CF/SCF) still remains controversy today, especially as regards to standardizing the therapy. Close reduction, though is a simple and widely used modality, anatomic reduction can be difficult to achieve compared with the open method. Many extraoral open surgical approaches have been proposed to improve functional rehabilitation by using osteosynthetic fixators. However, the resulting visible scar and possible facial nerve injury is the potentially risk that may make surgeons hesitate to perform open approach. The advent of endoscopic-assisted approach that allows reduction of fracture segments and fixation with miniplates via transoral incision has drawn considerable attention from surgeons and patients. Endoscope permits a limited surgical approach for segments reduction and placement of internal fixators by transbuccal method or angulated screw drives. Although the idea is straightforward, the manipulation is quite technique sensitive and usually need a steep learning curve. The talk will focus on the review of current management of CF/SCF and personal experience on endoscopically assisted approach.

Edward Chengchuan KO

Name: Edward Chengchuan KO, PhD, DDS, MS

E mail: ko.edward.kaseizen@gmail.com

Education:

1.      PhD, Surgical Science, The University of Tokyo, Japan (certificated on March 24, 2010)

2.      MS, Oral and Maxillofacial Surgery, Kaohsiung Medical University, Taiwan

3.      DDS, School of Dentistry, Kaohsiung Medical College, Taiwan

Current Position

l   Assistant Professor, Divison of Oral and Maxillofacial Surgery, Kaohsiung Medical University

l   Researcher, Dept. of FUJISOFT Cartilage and Bone Regeneration, Tissue Engineering, The U of Tokyo　

l   Attending surgeon, Dept. of Oral and Maxillofacial Surgery, Hospital of Kaohsiung Medical University

Diploma

l   Certificated Maxillofacial Surgeon of Taiwan

l   Certificated Facial plastic and reconstructive surgeon of Taiwan

Language：Taiwanese, Taiwanese Mandarin, English

Learning: Japanese (Level 2, certificated),

German (Level 3, 4, 5 certificated by German, Austrian and Swiss Embassies in Tokyo)

History in Profession

July 18, 1995 Admitted to Army Medical School for military training

Oct 11, 1995 Medical Officer ranked as Second Lieutenant in Medical Station of Infantry Division 146, the 8^th Corps of Taiwanese Army

June 2, 1997 Finished military service from Army

July 1, 1997 Resident, Dept of Oral and Maxillofacial Surgery, Kaohsiung Medical    University Hospital

Aug 1, 2000 Chief Resident, Dept of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital

July 31, 2001 training course: finished

Aug 1, 2001 Fellow and head, Dept of Oral and Maxillofacial Surgery, Kaohsiung Chang Kung Memorial Hospital

June 30, 2002 Fellowship: finished

Aug 1, 2002 Attending Surgeon, Dept of Oral and Maxillofacial Surgery, Taichung China Medical University Hospital

Feb 28, 2006 Resigned for advanced study in Tokyo U. 

Sep 1, 2008 - Mar 31 2010 Research Assistant of Global COE program

Arp 1, 2010 - now Researcher, Fujisoft Dept (Lab) of Cartilage and Bone Regeneration, The University of Tokyo, Japan

Reviewer of International Journal of Oral and Maxilllofacial Surgery since 2007

License of Taiwanese dentist: Dentist 008293

License of Taiwanese Oral and Maxillofacial Surgeon: OMFS 203

Specialist as Taiwanese Facial Reconstructive and Plastic Surgeon

Overseas training

1.      Orthognathic surgery： at Karl-Frazen Universität, Graz, Austria in Nov and Dec of 2003

2.      Free flap, microsurgery：at Karl-Frazen Universitä , Graz, Austria in July of 2004 The 6^th microvascular surgery course, European Association of Craniomaxillofacial Surgery)

3.      Cosmetic surgery training: Department of Oral and Maxillofacial Surgery, Institute of Anatomy, Vienna University, Austria in Aug of 2005

4.      Cosmetic surgery at Jelim Plastic Surgery Clinic, Seoul, Korea in Jan of 2011

5.      Clinical visit and observation at China Medical University in Shenyang in Feb of 2011

6.      Clinical visit and observation at the 9^th People’s Hospital in Shanghai in March of 2011

7.      Cosmetic Surgery at Jelim Plastic Surgery Clinic, Seoul, Korea in May of 2011

8.      Orthognathic Surgery at St Mary’s Hospital of Catholic University, Seoul, Korea in Jan, 2015

Member of：

1.      Member at large, Executive Counsel, Asian Association of Oral and Maxillofacial Surgeons

2.      Taiwan Association of Oral and Maxillofacial Surgery

3.      Counsel member of Taiwan Association of Oral and Maxillofacial Surgery

4.      Fellow, International Association of Oral and Maxillofacial Surgery

5.      Member of Asian Association of Oral and Maxillofacial Surgery

6.      Associate member, European Association of Craniomaxillofacial Surgery

7.      Taiwan Academy of Facial Plastic and Reconstructive Surgery

8.      Member of Japanese Society of Regenerative Medicine

9.      Member of Japanese Society of Jaw Deformities

SCI paper

From 2009 – 2013

1.          Hsu HJ, Yang YH, Shieh TY, Chen CH, Kao YH, Yang CF, Ko EC. * (2015, Mar). TGF-β1 and IL-10 single nucleotide polymorphisms as risk factors for oral cancer in Taiwanese. Kaohsiung J Med Sci., 31卷3期、123-9. As corresponding author

2.          Ko EC, Chang CM, Chang P, Kao CC, Chen KJ, Wu IF, Chen MY. (2015, Jan). Tibial Cancellous Bone Grafting in Jaw Reconstruction: 10 Years of Experience in Taiwan.. Clin Implant Dent Relat Res. 2015 Jan;, 17 Suppl 1:e321-31.. (Accepted).

3.          Hsiao CN, Ting CC, Shieh TY, Ko EC. * (2014, Nov). Relationship between betel quid chewing and radiographic alveolar bone loss among Taiwanese aboriginals: a retrospective study. BMC Oral Health. 2014 Nov 4;14:133. doi: 10.1186/1472-6831-14-13. BMC Oral Health., 4;14:133. As corresponding author

4.          Hsu HJ, Yang YH, Shieh TY, Chen CH, Kao YH, Yang CF, Ko EC. *  (2014, Nov). Role of cytokine gene (interferon-γ, transforming growth factor-β1, tumor necrosis factor-α, interleukin-6, and interleukin-10) polymorphisms in the risk of oral precancerous lesions in Taiwanese. Kaohsiung J Med Sci. 2014 Nov; 30(11):551-8. doi: 10.1016/j.kjms.2014.09.003. Epub 2014 Oct 27.. Kaohsiung J Med Sci. , 30(11):551-8. As corresponding author

5.          Lin CY, Pan TS, Ting CC, Liang SS, Huang SH, Liu HY, Ko EC, Wu CW, Tang JY, Chen PH* (2013, Aug). Cytochrome p450 metabolism of betel quid-derived compounds: implications for the development of prevention strategies for oral and pharyngeal cancers. 2013 Aug 1;2013:618032. doi: 10.1155/2013/618032. eCollection 2013.. Scientific World Journal..

6.          Ko EC, Fujihara Y, Ogasawara T, Asawa Y, Nishizawa S, Nagata S, Takato T, Hoshi K. (2012, May). BMP-2 embedded atelocollagen scaffold for tissue-engineered cartilage cultured in the medium containing insulin and triiodothyronine--a new protocol for three-dimensional in vitro culture of human chondrocytes.. Tissue Eng Part C Methods. 2012 May;18(5):374-86., 374-86.

7.          Chia-Ming Chang, Edward C. Ko, Chu-Chiang Kao, Pei-Ying Chang, Michael Y.C. Chen (2012, Apr). Incidence and clinical significance of zygomaticomaxillary complex fracture involving the temporomandibular joint with emphasis on trismus. Kaohsiung Journal of Medical Sciences (2012) 28, 336-340, 336-340.

8.          Ko EC, Fujihara Y, Ogasawara T, Asawa Y, Nishizawa S, Nagata S, Takato T, Hoshi K. (2011, May). Administration of the insulin into the scaffold atelocollagen for tissue-engineered cartilage. J Biomed Mater Res A. 2011 May;97(2):186-92., 186-92..

9.          Ko EC, Chen MY, Hsu M, Lai S. (2009, Dec). Intraoral approach for arthroplasty for correction of TMJ ankylosis.. Int. J. Oral Maxillofac. Surg. 2009; 38: 1256–1262, 38(12):1256-62.

10.      Edward Chengchuan Ko, Yee-Hsiung Shen, Chia-Fu Yang, DDS, I-Yueh Huang,Tien-Yu Shieh, Chun-Ming Chen (2009, Mar). Artificial Dermis as the Substitute for Split-Thickness Skin Graft in the Treatment of Oral Submucous Fibrosis. The Journal of Craniofacial Surgery Volume 20, Number 2, March 2009.

11.      D. Chikazu, Y. Mori,H. Saijo, H. Fujihara, E. C. Ko, H. Hikiji,Y. Yonehara, T. Takato (2008, Feb). A case of tumoural calcinosis in the temporomandibular joint associated with systemic sclerosis. Int. J. Oral Maxillofac. Surg. 2008; 37: 190–193, 190–193.

Current Study

1.      The effect of Collagen-binding domain BMP-4 on tissue-engineered cartilage

2.      Facial features among Formosan aborigines

3.      Comparison of Osteogenesis among tibia cancellous bone graft and iliac bone graft.