Top

Surgical and Radiologic Anatomy

Published in:

01-10-2017 | Original Article

Retraction force necessary to expose the mandibular neck in Risdon and high cervical anteroparotid transmasseteric approaches: an anatomic comparative study

Authors: Jérôme Adnot, Aliosha Feuss, Fabrice Duparc, Olivier Trost

Published in: Surgical and Radiologic Anatomy | Issue 10/2017

Abstract

Purpose

The purpose of this anatomic study was to compare the retraction force necessary to expose the mandibular neck in the Risdon and the high cervical anteroparotid transmasseteric (HAT) approaches.

Methods

An anatomic study was performed on 18 formalin-embalmed cadavers. We performed a Risdon approach on the left side, and an HAT approach on the right side in all the cases. The subjects were placed in a normative frame and the force necessary to maintain a satisfactory exposure of the condyle was measured with a system of cables, pulleys, and mechanical dynamometer. The statistical comparison between the two sides was carried out using the Wilcoxon signed-rank test for paired series.

Results

In all the cases, the region of interest was exposed as in the operating room. In the Risdon approach, the mean force was 32 Newtons (4–47). In the HAT approach, the mean force was 19 Newtons (4–33). The difference was statistically significant (p < 0.001). The age, gender, and duration of conservation had no influence on the retraction force.

Conclusion

In the HAT approach, the retraction of the soft tissues was significantly lower than in the Risdon approach. This study gave an additional explanation to the remarkable safety of the HAT approach. Our results were in favor of the generalization of this technique.

Arcuri F, Bruccoli M, Baragiotta N, Benech R, Ferrero S, Benech A (2012) Analysis of complications following endoscopically assisted treatment of mandibular condylar fractures. J Craniofac Surg 23:196–198. doi:10.1097/SCS.0b013e31824de328 CrossRef

Al-Moraissi EA, Ellis E 3rd (2015) Surgical treatment of adult mandibular condylar fractures provides better outcomes than closed treatment: a systematic review and meta-analysis. J Oral Maxillofac Surg 73:482–493. doi:10.1016/j.joms.2014.09.027 CrossRefPubMed

Benkhadra M, Bouchot A, Gérard J, Genelot D, Trouilloud P, Martin L, Girard C, Danino A, Anderhuber F, Feigl G (2011) Flexibility of Thiel’s embalmed cadavers: the explanation is probably in the muscles. Surg Radiol Anat 33:365–368. doi:10.1007/s00276-010-0703-8 CrossRefPubMed

Bhutia O, Kumar L, Jose A, Roychoudhury A, Trikha A (2014) Evaluation of facial nerve following open reduction and internal fixation of subcondylar fracture through retromandibular transparotid approach. Br J Oral Maxillofac Surg 52:236–240. doi:10.1016/j.bjoms.2013.12.002 CrossRefPubMed

Cheynet F, Aldegheri A, Chossegros C, Bourezak Z, Blanc JL (1997) The retromandibular approach in fractures of the mandibular condyle. Rev Stomatol Chir Maxillofac 98:288–294PubMed

Chrcanovic BR (2015) Surgical versus non-surgical treatment of mandibular condylar fractures: a meta-analysis. Int J Oral Maxillofac Surg 44:158–179. doi:10.1016/j.ijom.2014.09.024 CrossRefPubMed

Cranin AN, Brooklyn NY (1975) Comparison of two submandibular incisions on the motor function of lower lip. Oral Surg Oral Med Oral Pathol 40:327–332CrossRefPubMed

Eckelt U, Gerber S (1981) Draw-screw osteosynthesis with a novel osteosynthesis instrument set in mandibular condyle fractures. Zahn Mund Kieferheilkd Zentralbl 69:485–490PubMed

Ellis E 3rd, McFadden D, Simon P, Throckmorton G (2000) Surgical complications with open treatment of mandibular condylar process fractures. J Oral Maxillofac Surg 58:950–958CrossRefPubMed

10.

Ellis E III, Zide MF (1995) Surgical approaches to facial skeleton. LWW, Philadelphia

11.

Kadlub N, Trost O, Duvernay A, Parmentier J, Wirth C, Malka G (2008) Orthopaedic treatment of extraarticular condylar fractures of the mandible: retrospective study of 39 unilateral cases. Rev Stomatol Chir Maxillofac 109:301–305. doi:10.1016/j.stomax.2008.05.005 CrossRefPubMed

12.

Lee L, Mueller RV, Lee K, Mathes SJ (1998) Endoscopic subcondylar fracture repair: functional, aesthetic and radiographic outcomes. Plast Reconstr Surg 102:1434–1443CrossRefPubMed

13.

Meyer C, Zink S, Chatelain B, Wilk A (2008) Clinical experience with osteosynthesis of subcondylar fractures of the mandible using TCP plates. J Craniomaxillofac Surg 36:260–268. doi:10.1016/j.jcms.2008.01.002 CrossRefPubMed

14.

Meyer C, Zink S, Wilk A (2006) Modified Risdon approach for the treatment of subcondylar fractures of the mandible. Rev Stomatol Chir Maxillofac 107:449–454CrossRefPubMed

15.

Nassif PS, Kokoska MS, Homan S, Cooper MH, Thomas JR (1998) Comparison of subperiosteal vs subgaleal elevation techniques used in forehead lifts. Arch Otolaryngol Head Neck Surg 124:1209–1215CrossRefPubMed

16.

Rastogi S, Sharma S, Kumar S, Reddy MP, Niranjanaprasad Indra B (2015) Fracture of mandibular condyle—to open or not to open: an attempt to settle the controversy. Oral Surg Oral Med Oral Pathol Oral Radiol 119:608–613. doi:10.1016/j.oooo.2015.01.012 CrossRefPubMed

17.

Risdon F (1933) Ankylosis of the temporomaxillary joint. Am Dent Assoc 21:933

18.

Shi D, Patill PM, Gupta R (2015) Facial nerve injuries associated with the retromandibular transparotid approach for reduction and fixation of mandibular condyle fracture. J Craniomaxillofac Surg 43:402–407. doi:10.1016/j.jcms.2014.12.009 CrossRefPubMed

19.

Tang W, Gao C, Long J, Lin Y, Wang H, Liu L, Tian W (2009) Application of modified retromandibular approach indirectly from the anterior edge of the parotid gland in the surgical treatment of condylar fracture. J Oral Maxillofac Surg 67:552–558. doi:10.1016/j.joms.2008.06.066 CrossRefPubMed

20.

Throckmorton GS, Ellis E 3rd (2000) Recovery of mandibular motion after closed and open treatment of unilateral mandibular condylar process fractures. Int J Oral Maxillofac Surg 29:421–427CrossRefPubMed

21.

Trost O, Abu El-Naaj I, Trouilloud P, Danino A, Malka G (2008) High cervical transmasseteric anteroparotid approach for open reduction and internal fixation of condylar fracture. J Oral Maxillofac Surg 66:201–204CrossRefPubMed

22.

Trost O, Trouilloud P, Malka G (2009) Open reduction and internal fixation of low subcondylar fractures of mandible through high cervical transmasseteric anteroparotid approach. J Oral Maxillofac Surg 67:2446–2451. doi:10.1016/j.joms.2009.04.109 CrossRefPubMed

23.

Trost O, Péron JM (2013) Latest trends in the surgical management of mandibular condyle fractures in France, 2005–2012. Rev Stomatol Chir Maxillofac Chir Orale 114:341–348. doi:10.1016/j.revsto.2013.05.004 PubMed

24.

Wang TM, Lin CL, Kuo KJ, Shih C (1991) Surgical anatomy of the mandibular ramus of the facial nerve in Chinese adults. Acta Anat (Basel) 142:126–131CrossRef

25.

Woltmann M, Faveri Rd, Sgrott EA (2006) Anatomosurgical study of the marginal mandibular branch of the facial nerve for submandibular surgical approach. Braz Dent J 17:71–74CrossRefPubMed

26.

Ziarah HA, Atkinson ME (1981) The surgical anatomy of the cervical distribution of the facial nerve. Br J Oral Surg 19:171–179CrossRefPubMed

27.

Zrounba H, Lutz JC, Zink S, Wilk A (2014) Epidemiology and treatment outcome of surgically treated mandibular condyle fractures. A five years retrospective study. J Craniomaxillofac Surg 42:879–884. doi:10.1016/j.jcms.2014.01.002 CrossRefPubMed

Title: Retraction force necessary to expose the mandibular neck in Risdon and high cervical anteroparotid transmasseteric approaches: an anatomic comparative study
Authors: Jérôme Adnot
Aliosha Feuss
Fabrice Duparc
Olivier Trost
Publication date: 01-10-2017
Publisher: Springer Paris
Published in: Surgical and Radiologic Anatomy / Issue 10/2017
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-017-1853-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Retraction force necessary to expose the mandibular neck in Risdon and high cervical anteroparotid transmasseteric approaches: an anatomic comparative study

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2017

The hippocampus: detailed assessment of normative two-dimensional measurements, signal intensity, and subfield conspicuity on routine 3T T2-weighted sequences

Triticeal cartilage: the forgotten cartilage

Median pericallosal artery with double proximal origin: case report and clinical consideration

Immobile cerebral veins in the context of positional brain shift: an undescribed risk factor for acute subdural hemorrhage

Multiple variations of the cerebral arteries associated with tetralogy of Fallot: a case report

The effects of choanal atresia on development of the paranasal sinuses and turbinates