2017-18 HSC Section 3 Green Book

H.-T. Liao et al. / Journal of Cranio-Maxillo-Facial Surgery 43 (2015) 1595 e 1601

Table 1 General data of patient in each group.

Mini-preauricular Other approaches

Case numbers

29

29

Age (years) mean range

30.5 (SD 14.5) (17 e 64)

34.3 (SD 13.2) (18 e 67)

Sex (male:female)

17:12

20:9

Fracture site Bilateral

7

3

Unilateral

22 36

26 36

Condylar neck

Approach method Mini-preauricular

36

0

Intraoral and endoscope

0 0 0

13

Facelift

2

Retromandibular

17

Associated facial fractures Mandible

22

27

Le Fort I

8 6

5 6

Zygoma, orbital fl oor

Fig. 2. Exposure of the condylar fracture through a mini-preauricular incision.

Injury to operation period (days)

7.1 (SD 4.4)

5.9 (SD 5.9)

Post-op stay (days)

7.8 (SD 7.5)

6.3 (SD 3.8)

Plating system

approaches including retromandibular, face-lift and endoscopic- assisted methods for management of condylar fractures. The mean age was 30.5 years (SD 14.5) and 34.3 years (SD 13.2) in the minimal preauricular incision and the other approach groups, respectively ( Table 1 ). There were no signi fi cant differences in the age and sex ratio between the two groups ( p > 0.05) ( Table 1 ). Motorcycle accident was the most common injury mechanism in both groups; with 62% and 72% in the minimal preauricular incision and the other approach groups, respectively. In the mini- preauricular group, there were 22 unilateral and seven bilateral condylar fractures ( Table 1 ). Twenty-six unilateral and three bilat- eral condylar fractures were noted in other approach group ( Table 1 ). The mean periods from initial accident to operation were 7.1 and 5.9 days in the mini-preauricular and the other approach groups, respectively. There was no signi fi cant difference in the postoperative hospital stay between the two groups (7.8 vs. 6.3 days in mini-preauricular and other approach groups, respectively). Out of 29 cases in the mini-preauricular incision group, one mini- plate was used in 11 cases, double miniplates in 11 cases and one miniplate with one microplate in seven cases. Out of 29 cases in other approach groups, one miniplate was used in 17 cases, double miniplates in nine patients and one miniplate with one microplate in three cases.

Single miniplate Double miniplates

11 (37.9%) 11 (37.9%)

17 (58.6%)

9 (31%)

One miniplate and one microplate 7 (24.1%)

3 (10.3%)

MMO < 35 mm was recognized as trismus which represented a limited range of TMJ motion.

2.4. Complications

Postoperative complications were recorded and compared be- tween the two groups including wound infection, hematoma, facial nerve injury including frontal, zygomatic, buccal and marginal mandibular branches, great auricular nerve injury, Frey's syn- drome, salivary fi stula and sialocele.

2.5. Statistics

All data are reported as mean (SD). Statistical comparisons be- tween the mini-preauricular incision group and the other approach group were carried out using the Wilcoxon e Mann e Whitney test to determine signi fi cant differences. A difference between the two groups with p < 0.05 was considered statistically signi fi cant.

3. Results

3.1. Demographic comparison between two groups

Twenty-nine patients (17 male, 12 female) received minimal preauricular incisions and 29 (20 male, 9 female) underwent other

Fig. 1. Use of serial coronal views of two-dimensional CT to de fi ne the incision over the preauricular area.

Fig. 3. Open reduction and internal fi xation of a condylar fracture through a mini-preauricular incision.

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