Treatment of Diacapitular Condylar Fractures

NCT02466269 | Completed DMC

• 1 other identifier: hui_owen
• Study Type: observational
• Target: 1
• Locations: 0 countries
• Sites: N/A

Brief Summary

A new surgical approach, denoted as the supratemporalis approach, was designed to treat diacapitular condylar fractures of the mandibular condyle.This approach prevented facial nerve injury and did not increase the frequency of other complications. Therefore, the investigators suggest this surgical procedure as a routine and safe approach to diacapitular condylar fractures, which can also be applied to temporomandibular joint（TMJ）and to the zygomatic arch.

Conditions

Mandibular Fractures

Keywords

Facial Nerve Injuries

Outcome Measures

Primary Outcomes (5)

• Change from facial nerve function at 24 hours postoperatively

  The patients were instructed to raise their eyebrows, wrinkle the forehead, gently close the eyes, blow the cheek and smile. Paralysis of the facial nerve was deemed to have occurred if these motions were not achieved.

  24 hours

• Change from facial nerve function at 1 week postoperatively

  The patients were instructed to raise their eyebrows, wrinkle the forehead, gently close the eyes, blow the cheek and smile. Paralysis of the facial nerve was deemed to have occurred if these motions were not achieved.

  1 week

• Change from facial nerve function at 3 months postoperatively

  The patients were instructed to raise their eyebrows, wrinkle the forehead, gently close the eyes, blow the cheek and smile. Paralysis of the facial nerve was deemed to have occurred if these motions were not achieved.

  3 months

• Change from facial nerve function at 6 months postoperatively

  The patients were instructed to raise their eyebrows, wrinkle the forehead, gently close the eyes, blow the cheek and smile. Paralysis of the facial nerve was deemed to have occurred if these motions were not achieved.

  6 months

• Change from facial nerve function at 12 months postoperatively

  The patients were instructed to raise their eyebrows, wrinkle the forehead, gently close the eyes, blow the cheek and smile. Paralysis of the facial nerve was deemed to have occurred if these motions were not achieved.

  12 months

Study Arms (1)

the preauricular approach

A classic preauricular incision was used to treat diacapitular condylar fractures

Procedure: The supratemporalis approach

Interventions

The supratemporalis approach PROCEDURE

The supratemporalis approach was applied in treatment of diacapitular condylar fractures

the preauricular approach

Eligibility Criteria

• Age: 4 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

patients with diacapitular condylar fractures

You may qualify if:

• clinical and radiographical diagnosis of DFs;

You may not qualify if:

• condylar fractures with undisplaced fractures;
• Fractures without the reduction of the condylar height;
• A obvious scar at the temporal region, affecting the placement of the original incision.

Sponsors & Collaborators

• Hui Li: lead
• West China College of Stomatology: collaborator

Related Publications (32)

• Amaratunga NA. A study of condylar fractures in Sri Lankan patients with special reference to the recent views on treatment, healing and sequelae. Br J Oral Maxillofac Surg. 1987 Oct;25(5):391-7. doi: 10.1016/0266-4356(87)90088-x.

  PMID: 3478083 BACKGROUND

• Silvennoinen U, Iizuka T, Lindqvist C, Oikarinen K. Different patterns of condylar fractures: an analysis of 382 patients in a 3-year period. J Oral Maxillofac Surg. 1992 Oct;50(10):1032-7. doi: 10.1016/0278-2391(92)90484-h.

  PMID: 1527654 BACKGROUND

• Chrcanovic BR, Abreu MH, Freire-Maia B, Souza LN. 1,454 mandibular fractures: a 3-year study in a hospital in Belo Horizonte, Brazil. J Craniomaxillofac Surg. 2012 Feb;40(2):116-23. doi: 10.1016/j.jcms.2011.03.012. Epub 2011 Mar 31.

  PMID: 21458284 BACKGROUND

• Ellis E 3rd, Moos KF, el-Attar A. Ten years of mandibular fractures: an analysis of 2,137 cases. Oral Surg Oral Med Oral Pathol. 1985 Feb;59(2):120-9. doi: 10.1016/0030-4220(85)90002-7. No abstract available.

  PMID: 3856795 BACKGROUND

• Marker P, Nielsen A, Bastian HL. Fractures of the mandibular condyle. Part 1: patterns of distribution of types and causes of fractures in 348 patients. Br J Oral Maxillofac Surg. 2000 Oct;38(5):417-21. doi: 10.1054/bjom.2000.0317.

  PMID: 11010766 BACKGROUND

• Loukota RA, Eckelt U, De Bont L, Rasse M. Subclassification of fractures of the condylar process of the mandible. Br J Oral Maxillofac Surg. 2005 Feb;43(1):72-3. doi: 10.1016/j.bjoms.2004.08.018.

  PMID: 15620780 BACKGROUND

• Lindahl L. Condylar fractures of the mandible. I. Classification and relation to age, occlusion, and concomitant injuries of teeth and teeth-supporting structures, and fractures of the mandibular body. Int J Oral Surg. 1977 Feb;6(1):12-21. doi: 10.1016/s0300-9785(77)80067-7.

  PMID: 402318 BACKGROUND

• THOMA KH. Treatment of condylar fractures. J Oral Surg (Chic). 1954 Apr;12(2):112-20. No abstract available.

  PMID: 13152606 BACKGROUND

• Zachariades N, Mezitis M, Mourouzis C, Papadakis D, Spanou A. Fractures of the mandibular condyle: a review of 466 cases. Literature review, reflections on treatment and proposals. J Craniomaxillofac Surg. 2006 Oct;34(7):421-32. doi: 10.1016/j.jcms.2006.07.854. Epub 2006 Oct 19.

  PMID: 17055280 BACKGROUND

• Spiessl B, Schroll K. Gelenkfortsatz und gelenkkopfchenfracturen (Fractures of the condylar neck and head). Spezielle frakture und luxationslehre (Textbook of specialised fractures and dislocations) BD. I/I. Stuttgart: Thieme. 1972.

  BACKGROUND

• Loukota RA, Neff A, Rasse M. Nomenclature/classification of fractures of the mandibular condylar head. Br J Oral Maxillofac Surg. 2010 Sep;48(6):477-8. doi: 10.1016/j.bjoms.2009.08.036. Epub 2009 Nov 6. No abstract available.

  PMID: 19896755 BACKGROUND

• Chrcanovic BR. Open versus closed reduction: diacapitular fractures of the mandibular condyle. Oral Maxillofac Surg. 2012 Sep;16(3):257-65. doi: 10.1007/s10006-012-0337-6. Epub 2012 Jul 28.

  PMID: 22842852 BACKGROUND

• He D, Yang C, Chen M, Bin J, Zhang X, Qiu Y. Modified preauricular approach and rigid internal fixation for intracapsular condyle fracture of the mandible. J Oral Maxillofac Surg. 2010 Jul;68(7):1578-84. doi: 10.1016/j.joms.2009.07.076.

  PMID: 20430506 BACKGROUND

• Hlawitschka M, Eckelt U. Assessment of patients treated for intracapsular fractures of the mandibular condyle by closed techniques. J Oral Maxillofac Surg. 2002 Jul;60(7):784-91; discussion 792. doi: 10.1053/joms.2002.33246.

  PMID: 12089693 BACKGROUND

• Molina CV, Moreno RO, Coloma OB, Meza VD, Silva MA. Preauricular approach: our alternative for surgical treatment of condylar fractures. International Journal of Oral and Maxillofacial Surgery. 2013;42:1236

  BACKGROUND

• Mohan AP, Jeevan Kumar KA, Venkatesh V, Pavan Kumar B, Patil K. Comparison of preauricular approach versus retromandibular approach in management of condylar fractures. J Maxillofac Oral Surg. 2012 Dec;11(4):435-41. doi: 10.1007/s12663-012-0350-1. Epub 2012 Apr 4.

  PMID: 24293937 BACKGROUND

• House JW. Facial nerve grading systems. Laryngoscope. 1983 Aug;93(8):1056-69. doi: 10.1288/00005537-198308000-00016.

  PMID: 6877014 BACKGROUND

• House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985 Apr;93(2):146-7. doi: 10.1177/019459988509300202. No abstract available.

  PMID: 3921901 BACKGROUND

• Rowe NL, Killey HC. Fractures of the facial skeleton: E. & S. Livingstone; 1955.

  RESULT

• Cascone P, Leonardi R, Marino S, Carnemolla ME. Intracapsular fractures of mandibular condyle: diagnosis, treatment, and anatomical and pathological evaluations. J Craniofac Surg. 2003 Mar;14(2):184-91. doi: 10.1097/00001665-200303000-00009.

  PMID: 12621288 RESULT

• Rowe NL, Killey HC. Fractures of the facial skeleton: Churchill Livingstone; 1968.

  RESULT

• Rowe NL. Surgery of the temporomandibular joint. Proc R Soc Med. 1972 Apr;65(4):383-8. doi: 10.1177/003591577206500438. No abstract available.

  PMID: 5024527 RESULT

• Al-Kayat A, Bramley P. A modified pre-auricular approach to the temporomandibular joint and malar arch. Br J Oral Surg. 1979 Nov;17(2):91-103. doi: 10.1016/s0007-117x(79)80036-0.

  PMID: 298842 RESULT

• Dolwick MF, Kretzschmar DP. Morbidity associated with the preauricular and perimeatal approaches to the temporomandibular joint. J Oral Maxillofac Surg. 1982 Nov;40(11):699-700. doi: 10.1016/0278-2391(82)90141-0. No abstract available.

  PMID: 6957557 RESULT

• Lima SM Jr, Asprino L, Moreira RW, de Moraes M. Surgical complications of mandibular condylar fractures. J Craniofac Surg. 2011 Jul;22(4):1512-5. doi: 10.1097/SCS.0b013e31821d4c6f.

  PMID: 21778851 RESULT

• Hall MB, Brown RW, Lebowitz MS. Facial nerve injury during surgery of the temporomandibular joint: a comparison of two dissection techniques. J Oral Maxillofac Surg. 1985 Jan;43(1):20-3. doi: 10.1016/s0278-2391(85)80008-2.

  PMID: 3855313 RESULT

• do Egito Vasconcelos BC, Bessa-Nogueira RV, da Silva LC. Prospective study of facial nerve function after surgical procedures for the treatment of temporomandibular pathology. J Oral Maxillofac Surg. 2007 May;65(5):972-8. doi: 10.1016/j.joms.2006.06.280.

  PMID: 17448850 RESULT

• Weinberg S, Kryshtalskyj B. Facial nerve function following temporomandibular joint surgery using the preauricular approach. J Oral Maxillofac Surg. 1992 Oct;50(10):1048-51. doi: 10.1016/0278-2391(92)90488-l.

  PMID: 1527657 RESULT

• Babakurban ST, Cakmak O, Kendir S, Elhan A, Quatela VC. Temporal branch of the facial nerve and its relationship to fascial layers. Arch Facial Plast Surg. 2010 Jan-Feb;12(1):16-23. doi: 10.1001/archfacial.2009.96.

  PMID: 20083736 RESULT

• Krayenbuhl N, Isolan GR, Hafez A, Yasargil MG. The relationship of the fronto-temporal branches of the facial nerve to the fascias of the temporal region: a literature review applied to practical anatomical dissection. Neurosurg Rev. 2007 Jan;30(1):8-15; discussion 15. doi: 10.1007/s10143-006-0053-5. Epub 2006 Nov 10.

  PMID: 17096156 RESULT

• Kim S, Matic DB. The anatomy of temporal hollowing: the superficial temporal fat pad. J Craniofac Surg. 2005 Sep;16(5):760-3. doi: 10.1097/01.scs.0000180010.83480.10.

  PMID: 16192853 RESULT

• Politi M, Toro C, Cian R, Costa F, Robiony M. The deep subfascial approach to the temporomandibular joint. J Oral Maxillofac Surg. 2004 Sep;62(9):1097-102. doi: 10.1016/j.joms.2003.10.013.

  PMID: 15346360 RESULT

MeSH Terms

Conditions

Mandibular Fractures; Facial Nerve Injuries

Condition Hierarchy (Ancestors)

Jaw Fractures; Maxillofacial Injuries; Facial Injuries; Craniocerebral Trauma; Trauma, Nervous System; Nervous System Diseases; Skull Fractures; Fractures, Bone; Wounds and Injuries; Facial Nerve Diseases; Mouth Diseases; Stomatognathic Diseases; Cranial Nerve Injuries; Cranial Nerve Diseases

Study Officials

• Lei Li, DMD

  Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: June 3, 2015
• First Posted: June 9, 2015
• Study Start: August 1, 2014
• Primary Completion: May 1, 2015
• Study Completion: May 1, 2015
• Last Updated: October 25, 2017

Record last verified: 2017-10