Infinitesimal Peri-angular Pterygomasseteric Transectioning Approach (IPPTA) for the Base Fractures of the Mandibular Co
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ORIGINAL ARTICLE
Infinitesimal Peri-angular Pterygomasseteric Transectioning Approach (IPPTA) for the Base Fractures of the Mandibular Condyle: A Preliminary Study Darpan Bhargava1,3
•
Yogesh Sharma2 • Sivakumar Beena3
Received: 15 July 2020 / Accepted: 4 September 2020 Ó The Association of Oral and Maxillofacial Surgeons of India 2020
Abstract Purpose To investigate a reliable and safe surgical access to the condylar base region with minimal surgical trauma to the surrounding anatomic structures. In an attempt to do so, to describe Infinitesimal Peri-angular Pterygomasseteric Transectioning Approach (IPPTA) for the management of base fractures of the mandibular condyle. Materials and Method A preliminary clinical study involving 20 patients was undertaken to treat patients with unilateral condylar base fracture of the mandible using IPPTA under general anaesthesia (GA). Various parameters assessed were adequacy of surgical access, wound healing at the incision site, marginal mandibular nerve injury, diet intake and complications post-operatively. Result This method provided adequate exposure to fractured condylar base for open reduction and internal fixation (ORIF) with uneventful post-operative recovery phase. There was no limitation to function which was identified by restoration of normal pre-trauma diet intake by 14th post& Darpan Bhargava [email protected] Yogesh Sharma [email protected] Sivakumar Beena [email protected] 1
Department of Oral and Maxillofacial Surgery, People’s College of Dental Sciences and Research Center, People’s University, Bhanpur, Bhopal, Madhya Pradesh 462037, India
2
Department of Dentistry, Netaj Subhash Chandra Bose Medical College, Tilwara Road, Doctors Colony, Medical College Colony, Jabalpur, Madhya Pradesh 482003, India
3
TMJ Consultancy Services (South East Asia), H-3/2, B.D.A Colony, Nayapura, Lalghati, Airport Road, Bhopal, Madhya Pradesh 462 001, India
operative day in more than 50% of the study patients. No complications were observed in any patients among the study population. Discussion The peri-angular approach has been discussed in the literature. The IPPTA highlights the use of a smaller incision providing an adequate exposure to the condylar base region for ORIF. Keywords Temporomandibular joint Trauma Minimal access surgery Key hole surgery Oral surgery Mandible Joint Condyle Fracture Bone
Introduction The condyle is an anatomically weak point in mandibular skeleton which fractures readily when subjected to specific forces in order to disrupt transmission of these forces to the skull base. The reported incidence of fractures of the mandible involving condyle ranges from 20 to 35% [1, 2]. When indicated, open reduction with internal fixation (ORIF) for the treatment of condylar fractures is an established norm considering the superior outcome in terms of radiographic evidences of achievable anatomic reduction, post-operative improvement in quality of life with early recovery to function and overall functional outcome in th
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