Dislocation Of Mandibular Condyle Research Articles

Mandibular condyle dislocation into the middle cranial fossa with open reduction and reconstruction with glenoid fossa prosthesis. Unusual case report and literature review.

Mandibular condyle dislocation into the middle cranial fossa with open reduction and reconstruction with glenoid fossa prosthesis. Unusual case report and literature review.. DOI: 10.20986/recom.2023.1392/2022

Mandibular Reconstruction with Scapular Systems: A Single-Center Case Series Involving 208 Flaps.

The scapular flap is the most versatile composite flap used for mandibular reconstruction. The purpose of this study was to review and summarize findings of cases of mandibular reconstruction with a scapular flap and describe associated outcomes and complications. A total of 208 microvascular scapular free flaps were performed for mandibular reconstruction in a total of 205 patients from 2003 to 2018. This study involved a retrospective review of all eligible patients' medical records. There were seven cases (3.4 percent) of microvascular thrombosis. Postoperative bone union was achieved by 201 patients, except for five with total flap necrosis and two with partial flap necrosis. There were four cases (1.9 percent) of mandibular condyle dislocation. Two major types of complications were observed at the donor site, including four cases of infection and six cases of scapular body fracture. Postoperative denture prosthesis was introduced to 97 patients (47.3 percent). Implant treatment was performed in 10 patients (4.9 percent). Functional and aesthetic outcomes were good to excellent. The scapular composite free flap for mandibular reconstruction was associated with favorable outcomes and demonstrated satisfactory results. Although scapular bone fracture is rare, patients who have undergone mandibular reconstruction using a scapular flap should be monitored for its presence. . Therapeutic, IV.

Intra Cranial Dislocation of Mandibular Condyle—10 Year Follow up of a Case and Review of Literature

Dislocation of the mandibular condyle into the middle cranial fossa is a rare event with only 59 cases having been reported in the English literature. The common etiology is road traffic accident. Epidemiology wise this injury is found commonly in children and young adults. This has been attributed to the undeveloped condyle being small and rounded. In this report we present a case of central dislocation of the mandibular condyle into the middle cranial fossa in a 20 year old female patient sustained in a road traffic accident. Computed tomography helped in early diagnosis and treatment of the patient. We also stress upon the need for long term follow up of the patient to prevent secondary complications of ankylosis.

Bilateral Posterior Dislocation of Mandibular Condyle: A Rare Entity in Maxillofacial Injuries.

Dislocation of the mandibular condylar head refers to ectopic positioning of the intact condylar head out of the glenoid fossa. Most commonly reported anterior dislocation results from anteromedial pull of the lateral pterygoid muscle and laxity of the surrounding tissue with advanced age. This case report brings forth a unique case of bilateral posterior condylar dislocation in an edentulous patient who reported after 4 weeks of traumatic injury. The condition was managed surgically by reduction of the dislocated condyle and placement of mersilene tape on one side and temporalis muscle on the other side as anchorage ligament to stabilize the condyle and prevent any future recurrence. The patient was maintained on long-term follow-up for up to one year with no reported recurrence or reduction in mouth opening. This is the first ever case report that highlights bilateral posterior dislocation of intact mandible unlike the previous four reports which have brought forth unilateral dislocation on English literature search. Posterior dislocation of mandibular condyle is encountered in edentulous patients who experience posteriorly directed impact which forces the condylar head behind the postarticular ridge. Unlike anterior dislocation, clinical features include reduced mouth opening and retruded mandible in bilateral dislocation. It has been observed that manual correction by pressing the mandible downwards and forwards yields good results in early cases. Cases that are reported late require surgical exploration for reduction and placement of anchorage ligament to prevent recurrence in unstable condyle.

Posttraumatic Lateral Dislocation of Mandibular Condyle: A Proposed New Classification with Report of 14 Dislocated Condyles.

Lateral dislocation of the intact mandibular condyle is a relatively uncommon clinical condition. Since the first description and classification of these dislocations given by Allen and Young, few classification systems have been proposed in literature with incorporation of different patterns of dislocations identified over the years. We share our clinical experience of nine cases of such dislocations with 14 dislocated condyles, and on the basis of clinical and radiological findings coupled with the review of existing classification systems, we propose a new classification system which includes all the possible patterns of such dislocations overcoming the major shortcomings of preexisting classification systems identified by the authors.

Bilateral Dislocation of Mandibular Condyles following General Anesthesia—An Overlooked Problem: A Case Report

Dislocation of mandibular condyles can occur following excessive mouth opening or traumatic injury to the temporomandibular joint. It can also occur during general anesthesia that at times may go un-noticed in the modern-day theater setup. Here, we describe a case of bilateral dislocation of mandibular condyle following orotracheal intubation for general anesthesia. Right condyle was dislocated into temporal fossa.

An unusual traumatic superolateral dislocation of mandibular condyle with right parasymphysis mandibular fracture: A report of rarity

We describe what is to our knowledge that anteromedial fracture dislocation of the mandibular condyle is common, but a superolateral dislocation of the mandibular condyle is quite rare, this type of dislocation is often misdiagnosed or completely overlooked and hence inadequately addressed. We report a case of a 35-year-old male patient in which there was a sagittal fracture of the right condyle and the lateral fragment was hooked on the zygomatic arch with contralateral superolateral dislocation of the left condyle and right parasymphysis fracture following a road traffic accident. The present report exhibits an atypical case and highlights its management.

Unusual Supero-Lateral Dislocation of Intact Bilateral Mandibular Condyles Associated with Right Parasymphysis Mandibular Fracture:A Case Report and Review of Literature

The dislocation of the mandibular condyle / condyles occurs most commonly in an anterior direction due to trauma. This is a known fact as due to pull of lateral pterygoid muscle. On the contrary, posterior, superior, or lateral dislocations of the intact mandibular condyle occur rarely, and very few such cases have been reported in the English language literature. The rarity of these dislocations can be attributed to the varying anatomy of the condyle, the direction of pull of muscles attached to the condyle and low incidence of skull base fractures from an indirect blow. A case of bilateral supero-lateral dislocation of the condyle associated with a symphyseal fracture is presented. We discuss the dynamics, diagnostic features and clinical management of such dislocations with extensive review of literature.

Unusual Supero-Lateral Dislocation of Intact Bilateral Mandibular Condyles Associated with Right Parasymphysis Mandibular Fracture:A Case Report and Review of Literature

The dislocation of the mandibular condyle / condyles occurs most commonly in an anterior direction due to trauma. This is a known fact as due to pull of lateral pterygoid muscle. On the contrary, posterior, superior, or lateral dislocations of the intact mandibular condyle occur rarely, and very few such cases have been reported in the English language literature. The rarity of these dislocations can be attributed to the varying anatomy of the condyle, the direction of pull of muscles attached to the condyle and low incidence of skull base fractures from an indirect blow. A case of bilateral supero-lateral dislocation of the condyle associated with a symphyseal fracture is presented. We discuss the dynamics, diagnostic features and clinical management of such dislocations with extensive review of literature.

TMJ´s Posterolateral Dislocation with Tympanic Plate Fracture – Case Report

Temporomandibular joint (TMJ) dislocation is characterized by mandibular condyle dislocation out of articular cavity, fixated in an abnormal position in which self-reduction it is not possible. The TMJ traumatic dislocation occurs after medium and high intensity trauma directly on the joint or on symphyseal area and it is generally associated to fractures. This report documents a case of an unusual posterolateral dislocation of the left condyle with tympanic plate fracture, insignificant fracture of mandibular condyle, and discuss about the clinical symptoms, classification of dislocations, and treatment. A list of similar cases from the last 10 years is also showed.

Superolateral dislocation of the intact mandibular condyle: report of a rare case with a review

Dislocation of the temporomandibular joint, which represents 3% of all dislocated joints reported in the body, occurs when the mandibular condyle is displaced anteriorly beyond the articular eminence. Although anterior dislocation of the mandibular condyle is well documented in the literature, superior, lateral, and posterior dislocation of the condyle is rare. Only a few reports documenting superolateral dislocation with anterior mandible fractures have been published in the past. However such dislocations without any associated fractures are even rarer. This report documents a case of superolateral dislocation of an intact mandible in a 48-year-old woman following a traumatic incident. This paper also reviews previously documented case reports and focuses on the causative mechanism, dynamics, and management of such dislocations.

Central dislocation of mandibular condyle into middle cranial fossa: a case report

Background & aim: Traumatic mandibular condylar injuries occur commonly and generally present as condylar neck fractures or dislocations of the temporomandibular joint. On the other hand, intrusion of the mandibular condyle into the middle cranial fossa, with or without a simultaneous fracture of the mandible, is extremely rare. This article presents the case of a young female with central dislocation of the right mandibular condyle after facial trauma.

Superolateral Dislocation of Bilateral Intact Mandibular Condyles: A Rare Case Series.

The dislocation of mandibular condyle is a clinical condition in which the head of condyle has been displaced out of the glenoid fossa. Complete dislocation of the mandibular condyle can occur in anterior, posterior, lateral and superior direction. Among these dislocations, bilateral superolateral dislocation of mandibular condyles is quite rare and often misdiagnosed. Because of its rare occurrence and unusual clinical course, the best treatment is debatable. We present the first case series of true bilateral superolateral dislocation of intact mandibular condyles (Type 2B) without fracturing the Zygomatic arch, associated with symphysis fracture. This article intends to provide information regarding the possible biomechanics and management of bilateral superolateral dislocation of mandibular condyles associated with symphysis fracture.

Proposed radiographic protocol for central superior mandibular condyle dislocation into the middle cranial fossa: apropos of a case

Some difficulties have been described in the diagnosis of a number of reported cases of central superior mandibular condyle dislocation, which involves intracranial penetration of the mandibular condyle. Given that radiology plays an important role in detecting this condition, we herein propose an imaging diagnostic protocol for the management of suspicious superior mandibular condyle dislocation to identify this condition and properly evaluate the damaged tissues. We make reference to the case of a 13-year-old girl, who presented at the age of 7 years with a superior dislocation of the left condyle, which was clinically diagnosed as a probable temporomandibular joint ankylosis.

Conservative reduction by lever action of Chronic Bilateral Mandibular Condyle Dislocation

The treatment of long-standing dislocation of the temporomandibular joint is broadly classified into open reduction and closed reduction. The current study presents a case of long-standing dislocation of the temporomandibular joint treated three years after dislocation. In this study, the authors evaluated the long-term outcome of conservative reduction by lever action of chronic bilateral mandibular condyle dislocation.

Conservative reduction by lever action of chronic bilateral mandibular condyle dislocation

Aims:The treatment of long-standing dislocation of the temporomandibular joint is broadly classified into open reduction and closed reduction. The current study presents a case of long-standing dislocation of the temporomandibular joint treated 3 years after dislocation. In this study, the authors evaluated the long-term outcome of conservative reduction by lever action of chronic bilateral mandibular condyle dislocation.Methodology:Manual repositioning of temporomandibular joint dislocation lasting for 3 years in a 31-year-old woman was attempted without success; therefore, conservative reduction by lever action was carried out because the patient declined treatment under general anesthesia.Results:The treatment was discontinued after 6 days because of the subluxation of the retaining tooth. The retainer was changed from tooth to screw for intermaxillary fixation, and treatment was reinstituted. Fifteen days later, reduction was achieved and retention was started and continued for 2 months. The outcome was good, with no recurrent dislocation within 24 months of the treatment.Conclusions:Conservative reduction by lever action, involving minimally invasive treatment and little dysfunction, should be considered an optional conservative treatment.

Traumatic Dislocation of the Mandibular Condyle Into the Middle Cranial Fossa in an Elderly Patient

Dislocation of the mandibular condyle into the middle cranial fossa is a rare traumatic injury caused by transmission of upward force through the condyle onto the glenoid fossa resulting in fracture of the fossa and superior displacement of the condylar head. This type of injury occurs when the "safety mechanisms" of the mandible fail or are absent. The authors present the case of a 72-year-old female patient with multiple comorbidities who suffered a subcondylar fracture of the left mandible and dislocation of the right mandibular condyle into the middle cranial fossa after a fall. Bilateral external fixation of the mandible to the zygomatic arch was utilized to minimize operative time and provide definitive treatment. Many factors must be taken into account when determining the treatment modality for this type of injury, and the final decision should be tailored to each individual case based on several factors including the length of time between injury and presentation, concomitant neurologic deficit, age, and stability of the patient. The goals of treatment are reduction of the dislocation, avoidance of neurologic injury, and restoration of mandibular function. A multidisciplinary effort is necessary to optimize patient care.

Superolateral Dislocation of Bilateral Intact Condyles—An Unusual Presentation: Report of a Case and Review of Literature

Dislocation of the mandibular condyle is the clinical condition of the condyle head being displaced out of the glenoid fossa but still remaining within the joint capsule. However, the anatomy of the mandibular condyle, glenoid fossa, and zygomatic arch usually prevent the dislocation of intact condyles out of the glenoid fossa whenever the mandible is subjected to high impact. Complete dislocation of the mandibular condyle from the glenoid fossa can be classified into four groups: anterior, posterior, lateral, and superior dislocation. All the groups except anterior dislocation are rare. Superolateral dislocation of the intact mandibular condyle occurs very rarely. We report a case of lateral dislocation of bilateral intact condyles associated with left parasymphysis fracture. The purpose of this report is to review all of the available English literature on this dislocation and discuss the possible causative mechanism and diagnostic features, as well as clinical management.

Functional Evaluation of the Use of Total TMJ Custom Prothesis in the Treatment of Fracture of the Middle Cranial Fossa by Condylar Impaction

Fracture of the middle cranial fossa by dislocation of mandibular condyle is a rare type of trauma, and only a few cases are reported in literature. This injury is more common among children and young adults than among the elderly. Most of these fracture have been treated in a open reduction, and variable outcomes have been reported, primarily the functional recovery of these patients. The aim of this paper is to present a follow-up of 2 years of a fracture of the cranial fossa by impaction of mandibular condyle treated with TMJ custom prothesis, where we perform the functional assessment preoperative and postoperative, analyzing the maximum incisal opening (MIO), protrusive (P), lateral excursive movements right and left (LR/LL) and deviation (D). Measurements of mandibular movements were made by the same professional using a caliper, the evaluation of the facial asymmetry and occlusion was performed by clinical and radiographic evaluation and pain assessment was performed using a specific questionnaire. The data were subjected to direct analysis of data and measures of central tendency. The patient evaluated had 19 year-old, female, victim of a motorcycle accident. The patient presented with pain, limited jaw movements, facial asymmetry and malocclusion. We did not observe neurological and ENT injuries. Evolved in right subcondilar fracture and middle cranial fossa by dislocation of the left condyle. Surgery was performed through open reduction with IRF on the right side and on the left a total TMJ custom prosthesis. There were no local or neurological complications during surgery and the patient underwent rehabilitation physiotherapy for 6 months and accompanied by two years. In functional evaluation pre and postoperative respectively had the following results: MIO increase 2mm to 40mm (38mm) LR increase 0mm to 3mm (3mm), LL increase 0mm to 5mm (5mm) and P increase 2mm to 5mm (5mm). The patient after clinical and radiographic evaluation showed no facial asymmetry and had good occlusion. The pain questionnaire answered by it showed that the patient did not have significant pain. The use of Total TMJ custom prosthesis for treatment of cases of fracture of the middle cranial fossa by impaction of the mandibular condyle, without neurological complications, seems an excellent choice, especially in functional recovery.

Tympanic Plate Fractures in Temporal Bone Trauma: Prevalence and Associated Injuries

The prevalence of tympanic plate fractures, which are associated with an increased risk of external auditory canal stenosis following temporal bone trauma, is unknown. A review of posttraumatic high-resolution CT temporal bone examinations was performed to determine the prevalence of tympanic plate fractures and to identify any associated temporal bone injuries. A retrospective review was performed to evaluate patients with head trauma who underwent emergent high-resolution CT examinations of the temporal bone from July 2006 to March 2012. Fractures were identified and assessed for orientation; involvement of the tympanic plate, scutum, bony labyrinth, facial nerve canal, and temporomandibular joint; and ossicular chain disruption. Thirty-nine patients (41.3 ± 17.2 years of age) had a total of 46 temporal bone fractures (7 bilateral). Tympanic plate fractures were identified in 27 (58.7%) of these 46 fractures. Ossicular disruption occurred in 17 (37.0%). Fractures involving the scutum occurred in 25 (54.4%). None of the 46 fractured temporal bones had a mandibular condyle dislocation or fracture. Of the 27 cases of tympanic plate fractures, 14 (51.8%) had ossicular disruption (P = .016) and 18 (66.6%) had a fracture of the scutum (P = .044). Temporomandibular joint gas was seen in 15 (33%) but was not statistically associated with tympanic plate fracture (P = .21). Tympanic plate fractures are commonly seen on high-resolution CT performed for evaluation of temporal bone trauma. It is important to recognize these fractures to avoid the preventable complication of external auditory canal stenosis and the potential for conductive hearing loss due to a fracture involving the scutum or ossicular chain.