Magnetic resonance imaging in the postsurgical evaluation of patients with mandibular condyle fractures treated using the transparotid approach: our experience

J Oral Maxillofac Surg. 2009 Sep;67(9):1815-20. doi: 10.1016/j.joms.2009.04.019.

Abstract

Purpose: To evaluate the morphostructural and functional modifications of the temporomandibular joint and the onset of parotid complications in patients with extracapsular monocondylar fractures treated by reduction with the application of a titanium microplate via a transparotid approach.

Materials and methods: The study was comprised of 20 patients (16 male patients and 4 female patients) with a mean age of 25 years (range, 15-44 years) who had undergone reduction of condyle fractures. Twelve months after surgery, all patients were examined by means of magnetic resonance imaging (MRI) of the temporomandibular joint and parotid gland on the treated side. MRI examination was performed by use of coronal T2-weighted turbo spin echo sequences, as well as parasagittal T1-weighted turbo spin echo and T2-weighted fast field echo sequences. Images were acquired from the resting position to the position of maximum oral opening.

Results: The 1-year clinical outcome in our patients was good. MRI showed, on the treated side, 5 cases of anterior dislocation of the disc (25%), 1 case of disc degeneration (5%), and 1 case of parotid fistula (5%).

Conclusion: Both trauma and surgical intervention can damage the meniscal capsuloligamentous complex. MRI allowed the complications due to the trauma and/or treatment to be identified and made it possible to compare the condyles and joint function.

MeSH terms

  • Adolescent
  • Adult
  • Bone Plates
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation
  • Humans
  • Magnetic Resonance Imaging / instrumentation
  • Magnetic Resonance Imaging / methods
  • Male
  • Mandibular Condyle / injuries*
  • Mandibular Condyle / pathology
  • Mandibular Condyle / surgery*
  • Mandibular Fractures / pathology
  • Mandibular Fractures / surgery*
  • Oral Surgical Procedures / methods*
  • Parotid Gland / pathology*
  • Parotid Gland / surgery
  • Postoperative Care
  • Temporomandibular Joint / injuries
  • Temporomandibular Joint / pathology*
  • Temporomandibular Joint / surgery
  • Treatment Outcome
  • Young Adult