This document discusses surgical approaches for treating mandibular condylar fractures. It describes several transcutaneous approaches like pre-auricular, retromandibular, and submandibular as well as intraoral endoscopic approaches. The preauricular approach involves making incisions above and below the tragus to expose the condylar head and neck. The retromandibular approach requires an incision behind the ramus to dissect through the parotid gland and expose the condylar neck. Selection of the best surgical approach depends on factors like the fracture level, existing lacerations, need for exposure, and risk of complications.
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surgical approaches to the mandibular condyle
1.
2. Dr. Asif Nazir
B.D.S., F.C.P.S. (Oral Surgery)
Senior Registrar,
Oral & Maxillofacial Surgery Department
de’Montmorency College of Dentistry,
Punjab Dental Hospital, Lahore.
7. Preauricular approach
Dingman’ approach
For condylar head & neck fractures
Incision consists of 2 limbs---one superior and
other inferior to tragus
Incision is placed in pre-auricular crease
through skin s/c tissue to the temporal fascia
8. Preauricular approach
Then undermining is
done towards the
zygomatic arch
An oblique incision is
made through the tissue
near the root of zygoma
to enter the the joint
capsule and expose the
condylar fracture.
17. Peri-auricuular approach
Pre-auricular approach
with lasy ‘S’ extansion
A trans-masseteric
anteroparotid approach
(TMAP).
Dissection in subdermal
fat plane to gain access
to the masseter adjacent
to antero-inferior edge of
parotid gland
20. Sub-mandibular approach
Also known as risdon approach
Incision is made 2 cm below the angle of
mandible
Skin, s/c tissue, platysma and deep
cervical fascia are incised and dissection
is performed superiorly to expose the sub
condylar fractures
21. Intraoral (endoscopic)approach
• Mandibular condylar fractures can be best
approached via intra-oral approach with
the help of endoscope.
• Maa and Fang (1994)were the first to use
endoscope for mandibular angle fracture.
• Jacobveiz used it for condylar fractures
first time.