Intraosseous lipomas are rare benign tumors of the bone, especially for the mandible. The etiology remains unclear, although several hypotheses have been proposed, such as trauma, blood vessel infarction, aging and inflammation. Clinically, the symptoms mainly depend on the location and size of the tumors. Radiographically, the lesions are usually radiolucent occasionally accompanied by radiopacity. The diagnosis is challenging, and histopathologic examination is necessary for definite diagnosis. Herein, the authors report an unusual patient with intraosseous lipoma in the mandibular condyle.

The aim of this meta-analysis was to evaluate the efficacy of open surgery and closed treatment for unilateral moderately displaced mandibular condyle fractures. PubMed, Embase, and Cochrane Library databases were searched according to PRISMA guidelines from inception to October, 2018. Inclusion criteria were based on humans randomized controlled trials in the English literature. Pertinent data were collected and the incidence of the complications was calculated. A total of 6 studies with 227 patients were included in the meta-analysis. The results showed that there were no significant differences in incidence of malocclusion (odds ratio [OR], 0.33; 95% confidence interval [CI]: 0.07-1.46; P = 0.14). However, open surgery group had a better maximal mouth opening (WMD = 3.82, 95% CI: 1.93-5.71, P < 0.01), protrusion (WMD = 1.16, 95% CI: 0.42-1.89, P < 0.01) and sum of both laterotrusions (WMD: 2.50, 95% CI: 1.77-3.22, P < 0.01). And the incidence of temporomandibular joint pain was lower than closed treatment group (OR: 0.15, 95% CI: 0.06-0.37, P < 0.01). Compared with closed treatment, open surgery has significant advantages in improving mouth opening and mandibular movement, and reducing the incidence of temporomandibular joint pain, provided that open surgery was a promising application in treatment of unilateral moderately displaced mandibular condyle fractures.

In surgical removal of a submandibular gland, trans-cervical approach has esthetic problem and existing trans-oral approaches are extensively invasive. The authors have used trans-oral robotic surgery to remove the submandibular gland with preservation of the sublingual gland and the Wharton's duct, and hereby report the case and discuss our preliminary experiences.