Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2019 Outcome of surgically treated fractures of the condylar process by an endoscopic assisted transoral approach Blumer, Michael ; Guggenbühl, Tobias ; Wagner, Maximilian E H ; Rostetter, Claudio ; Rücker, Martin ; Gander, Thomas Abstract: Purpose Fractures of the condylar process are frequent. Ideal management of these fractures, as discussed in the literature, is controversial. Some recent meta-analyses have favored open reduction and internal fxation using various approaches. A strictly transoral approach has been described to minimize scarring and risk of facial nerve injury but has restricted visibility. This retrospective study analyzed outcomes of patients with unilateral mandibular condyle fractures who were treated by open reduction and internal fxation through an endoscopic-assisted transoral approach. Materials and Methods This study included 40 patients who were operated on from January 2015 through December 2016. All pa- tients underwent surgery for a condylar process fracture using an endoscopic-assisted transoral approach. Fracture classifcation, demographic, and outcome data were collected. Results Most condylar process fractures were caused by falls from a height less than 3 m. Most were condylar base fractures and classifed according to Spiessl and Schroll as Classes I and II. Sixteen patients showed a preoperative malocclusion, whereas 2 patients showed a slight postoperative malocclusion. In cases in which only 1 plate could be placed, the proximal fragment was shorter. A higher Spiessl and Schroll class showed a tendency toward longer operation times. For postoperative outcomes, 1 case of temporary facial palsy was the worst com- plication (2.5%), 2 cases exhibited minimal occlusal interference (5%), and 1 case exhibited a deviated mouth opening (2.5%). Ramus height was restored in all cases. No chronic pain was found in any cases. DOI: https://doi.org/10.1016/j.joms.2018.08.013 Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-153603 Journal Article Accepted Version The following work is licensed under a Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License. Originally published at: Blumer, Michael; Guggenbühl, Tobias; Wagner, Maximilian E H; Rostetter, Claudio; Rücker, Martin; Gander, Thomas (2019). Outcome of surgically treated fractures of the condylar process by an endoscopic assisted transoral approach. Journal of Oral and Maxillofacial Surgery, 77(1):133.e1-133.e9. DOI: https://doi.org/10.1016/j.joms.2018.08.013
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Zurich Open Repository andArchiveUniversity of ZurichMain LibraryStrickhofstrasse 39CH-8057 Zurichwww.zora.uzh.ch
Year: 2019
Outcome of surgically treated fractures of the condylar process by anendoscopic assisted transoral approach
Blumer, Michael ; Guggenbühl, Tobias ; Wagner, Maximilian E H ; Rostetter, Claudio ; Rücker, Martin; Gander, Thomas
Abstract: Purpose Fractures of the condylar process are frequent. Ideal management of these fractures, asdiscussed in the literature, is controversial. Some recent meta-analyses have favored open reduction andinternal fixation using various approaches. A strictly transoral approach has been described to minimizescarring and risk of facial nerve injury but has restricted visibility. This retrospective study analyzedoutcomes of patients with unilateral mandibular condyle fractures who were treated by open reductionand internal fixation through an endoscopic-assisted transoral approach. Materials and Methods Thisstudy included 40 patients who were operated on from January 2015 through December 2016. All pa-tients underwent surgery for a condylar process fracture using an endoscopic-assisted transoral approach.Fracture classification, demographic, and outcome data were collected. Results Most condylar processfractures were caused by falls from a height less than 3 m. Most were condylar base fractures and classifiedaccording to Spiessl and Schroll as Classes I and II. Sixteen patients showed a preoperative malocclusion,whereas 2 patients showed a slight postoperative malocclusion. In cases in which only 1 plate could beplaced, the proximal fragment was shorter. A higher Spiessl and Schroll class showed a tendency towardlonger operation times. For postoperative outcomes, 1 case of temporary facial palsy was the worst com-plication (2.5%), 2 cases exhibited minimal occlusal interference (5%), and 1 case exhibited a deviatedmouth opening (2.5%). Ramus height was restored in all cases. No chronic pain was found in any cases.
DOI: https://doi.org/10.1016/j.joms.2018.08.013
Posted at the Zurich Open Repository and Archive, University of ZurichZORA URL: https://doi.org/10.5167/uzh-153603Journal ArticleAccepted Version
The following work is licensed under a Creative Commons: Attribution-NonCommercial-NoDerivatives4.0 International (CC BY-NC-ND 4.0) License.
Originally published at:Blumer, Michael; Guggenbühl, Tobias; Wagner, Maximilian E H; Rostetter, Claudio; Rücker, Martin;Gander, Thomas (2019). Outcome of surgically treated fractures of the condylar process by an endoscopicassisted transoral approach. Journal of Oral and Maxillofacial Surgery, 77(1):133.e1-133.e9.DOI: https://doi.org/10.1016/j.joms.2018.08.013
Accepted Manuscript
Outcome of surgically treated fractures of the condylar process by an endoscopicassisted transoral approach
Michael Blumer, MD, DMD, Tobias Guggenbühl, Maximilian Wagner, MD, DMD,Claudio Rostetter, MD, DMD, Martin Rücker, MD, DMD, Thomas Gander, MD, DMD
PII: S0278-2391(18)30977-7
DOI: 10.1016/j.joms.2018.08.013
Reference: YJOMS 58423
To appear in: Journal of Oral and Maxillofacial Surgery
Received Date: 29 March 2018
Revised Date: 15 August 2018
Accepted Date: 15 August 2018
Please cite this article as: Blumer M, Guggenbühl T, Wagner M, Rostetter C, Rücker M, Gander T,Outcome of surgically treated fractures of the condylar process by an endoscopic assisted transoralapproach, Journal of Oral and Maxillofacial Surgery (2018), doi: 10.1016/j.joms.2018.08.013.
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Outcome of surgically treated fractures of the condylar process by
an endoscopic assisted transoral approach
Michael Blumer, MD, DMD1), Tobias Guggenbühl 2), Maximilian Wagner, MD, DMD3),
Claudio Rostetter, MD, DMD1), Martin Rücker, MD, DMD4), Thomas Gander, MD,
DMD3)
1) Resident, Clinic for Cranio-Maxillofacial Surgery, University Hospital, Zurich, Switzerland
2) Post-graduate, Clinic for Cranio-Maxillofacial Surgery, University Hospital, Zurich,
Switzerland
3) Fellow, Clinic for Cranio-Maxillofacial Surgery, University Hospital, Zurich, Switzerland
4) Professor and Medical Director, Clinic for Cranio-Maxillofacial Surgery, University Hospital,