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KMID : 0358820100370020161
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Journal of Korean Society of Plastic and Reconstructive Surgeons
2010 Volume.37 No. 2 p.161 ~ p.168
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Transmasseteric Approach for Open Reduction and Internal Fixation of Mandible Subcondylar Fracture
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Kim Hak-Soo
Kim Seong-Eon
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Abstract
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Purpose: Surgical approaches to the condylar neck and subcondyle area can cause some morbidity such as, facial nerve injury, time-consuming nature and external scar etc. So many surgeons hesitate using open reduction and internal fixation for the treatment of subcondylar fractures. We report open reduction and internal fixation of subcondylar fractures in 13 adult patients via transmasseteric approach.
Methods: From 2007 to 2009, 13 adults with subcondylar fracture of mandible were treated with open reduction and internal fixation via transmasseteric approach. A preauricular incision was extended downwards in a curvilinear fashion in the cervicomastoid skin crease. Skin flap was elevated above the SMAS layer. Masseter muscle was splitted at the anteroinferior edge of the parotid gland. After the fracture was reduced, fixed with appropriate plates and screws. All operation were performed under general anesthesia.
Results: Mean follow-up period was 13.3 months. There were no signs and symptoms of facial nerve injury, difficulty in mouth opening, or malocclusion. Dissection time was roughly within 30 minutes. Received December 30, 2009 Revised January 21, 2010 Accepted February 9, 2010 Address Correspondence: Hak Soo Kim, M.D., Department of Plastic and Reconstructive Surgery, Pohang Semyeong Christianity Hospital, 94-5 Daedo-dong, Nam-gu, Pohang, Gyeongbuk-do 790-822, Korea. Tel: 054)289-1720/Fax: 054) 289-1766/E-mail: pskimhs@hanmail.net * 본 논문은 2009년 대한성형외과학회 추계학술대회에서 구연 발표되었음
Conclusion: Transmasseteric open reduction and internal fixation of mandible subcondylar fracture can be performed with excellent visualization, and inconspicuous scar. It also offers swift access to the subcondylar area while substatially reducing the risk to the facial nerve and eliminating the complications associated with transparotid approaches.
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KEYWORD
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Subcondylar fracture, Transmasseteric approach
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