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.
