Universität zu Köln

Buller, Johannes, Noetzel, Nicolas ORCID: 0000-0002-1826-1001, Kroeger, Nadja, Zoeller, Joachim E. and Zirk, Matthias (2022). Outcomes of the Nonendoscopic Transoral Approach to Subcondylar Mandible Fractures. J. Oral Maxillofac. Surg., 80 (1). S. 114 - 121. PHILADELPHIA: W B SAUNDERS CO-ELSEVIER INC. ISSN 1531-5053

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Abstract

Purpose: The transoral approach (TRA) to subcondylar fractures without any endoscopic or transbuccal assistance is not a common technique. The purpose of this study was to measure and compare the quality of open reduction and internal fixation (ORIF) between the TRA and the retromandibular approach (RMB), including types and frequencies of postoperative complications. Methods: In our retrospective cohort study, we enrolled a sample of patients with displaced subcondylar mandible fractures treated by ORIF. The predictor was the approach mode: TRA or RMB. In postoperative computed tomography (CT) data sets, we measured the angles of the condylar process in relation to references: 1) midline, 2) lateral ramus border, and 3) posterior ramus border. The primary outcome variable was the reduction outcome, which was calculated as the difference between the total of all angles of the operated side and the non-affected side. Secondary outcomes were postoperative complications extracted from patients' files. Other variables were age, gender, number of plates, operation time and a modified AO trauma score. In bivariate analysis, we compared the outcome between both groups. Results: Sixty-four patients were included in total, with TRA performed in 50%. Patients with TRA were younger (31 vs 41, P = .003), and the trauma score was lower (1.9 vs 3.3, P < .001). Reduction outcome remained comparable between both techniques (mean 3.7 degrees for both, P = .92). Complication rates were similar, although facial nerve palsy was absent for TRA (0 vs 4, P = .039). Conclusion: We suggest TRA for selected patients with displaced, single fragmented subcondylar fractures. Reduction outcome shows a comparable exactness to RMB, while TRA is safer for the facial nerve. (C) 2021 The American Association of Oral and Maxillofacial Surgeons.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Buller, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Noetzel, Nicolas UNSPECIFIED orcid.org/0000-0002-1826-1001 UNSPECIFIED Kroeger, Nadja UNSPECIFIED UNSPECIFIED UNSPECIFIED Zoeller, Joachim E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zirk, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-562982
DOI:	10.1016/j.joms.2021.07.026
Journal or Publication Title:	J. Oral Maxillofac. Surg.
Volume:	80
Number:	1
Page Range:	S. 114 - 121
Date:	2022
Publisher:	W B SAUNDERS CO-ELSEVIER INC
Place of Publication:	PHILADELPHIA
ISSN:	1531-5053
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CONDYLAR PROCESS FRACTURES; RIGID INTERNAL-FIXATION; ASSISTED OPEN REDUCTION; RETROMANDIBULAR APPROACH; CLOSED TREATMENT; CLASSIFICATION; OSTEOSYNTHESIS; METAANALYSIS; SYSTEM; PLATES Multiple languages Dentistry, Oral Surgery & Medicine Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56298