하악 과두하 골절시 구강내 접근의 문헌 고찰과 임상 연구

서현수; 홍순민; 유승은; 박준우

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하악 과두하 골절시 구강내 접근의 문헌 고찰과 임상 연구
THE LITERACTURE REVIEW AND CLINICAL EVALUATION OF INTRAORAL APPROACH FOR SUBCONDYLAR FRACTURE

대한구강악안면외과학회지 2008년 34권 6호 p.644 ~ 648

서현수, 홍순민, 유승은, 박준우,

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서현수 ( Seo Hyun-Soo ) - 한림대학교 의과대학 구강악안면외과학교실
홍순민 ( Hong Soon-Min ) - 한림대학교 의과대학 구강악안면외과학교실
유승은 ( You Seong-Eun ) - 한림대학교 의과대학 구강악안면외과학교실
박준우 ( Park Jun-Woo ) - 한림대학교 의과대학 구강악안면외과학교실

KMID : 0355620080340060644

Abstract

Purpose: The aim of this study was to investigate the clinical cases of subcondylar fracture with intraoral approach.

Materials and Methods : Fifteen patients with unilateral subcondylar fracture were treated in the department of oral and maxillofacial surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University between 2006 and 2007. Each patients was examined by computed tomography(CT) and panorama. 3D-CT taken when fractured segment was displaced and comminuted. Patients was done intermaxillary fixation to occlusal stability and prevent displacement of fractured segment before general operation. Open reduction and internal fixation(ORIF) accomplished under general anesthesia and used to intraoral approach. We examinated the state of occlusion, maximum opening. Evaluation of the state of occlusion was divided in patient`s subjective evaluation that compare pre-traumatic occlusion with postoperative occlusion, and estimator`s objective evaluation that use articulating paper. Examination was done at 2 weeks, 1, 3, 6 month postoperative by follow up.

Result: The ORIF through intraoral approach was good in all patients. In the state of occlusion, all patients recovered pre-traumatic occlusion in 6 month postoperation. Maximum opening was gradually increased. In 3 month postoperative, maximum opening was excessed 40mm.

Conclusion: Our study indicate that the intraoral approach is a good technique for subcondylar fracture. Intraoral approach prevent complication that facial nerve damage, scar formation caused by extraoral approach. So, we recommend intraoral approach when subcondylar fracture.