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Yoshida K. Superior Dislocation of the Mandibular Condyle into the Middle Cranial Fossa: A Comprehensive Review of the Literature. J Clin Med 2023; 12:jcm12113781. [PMID: 37297975 DOI: 10.3390/jcm12113781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/29/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
The superior dislocation of the condyle into the cranium occasionally requires invasive procedures due to the absence of a timely diagnosis. This review analyzed the available clinical data to provide information on treatment decisions. The reports were assessed using electronic medical databases from inception to 31 October 2022. A total of 116 cases from 104 studies were assessed; among the patients, 60% and 87.5% of the affected women and men required open reduction, respectively. The ratio of closed to open procedures within 7 days after injury was maintained; however, closed reduction decreased over time, and all cases required open reduction after 22 days. Eighty percent of the patients with a total intrusion of the condyle required open reduction, whereas the frequency for both procedures was comparable in the remaining patients. Open reduction was significantly more frequently performed for men (p = 0.026, odds ratio; 4.959, 95% confidence interval; 1.208-20.365) and less frequently performed in cases with partial intrusion (p = 0.011; odds ratio: 0.186; 95% confidence interval: 0.051-0.684); the frequency varied according to the time until treatment (p = 0.027, odds ratio; 1.124, 95% confidence interval; 1.013-1.246). Appropriate diagnostic imaging and prompt diagnosis are indispensable for minimally invasive treatment of this condition.
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Affiliation(s)
- Kazuya Yoshida
- Department of Oral and Maxillofacial Surgery, National Hospital Organization, Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan
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Ali IK, Sansare K, Karjodkar FR, Salve P, Vanga K, Pawar AM. Maxillofacial trauma patterns associated with external auditory canal fractures: Cone beam computed tomography analysis. Dent Traumatol 2017; 33:276-280. [PMID: 28296040 DOI: 10.1111/edt.12336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS There is a paucity of literature on external auditory canal (EAC) fractures secondary to maxillofacial trauma, with most of the literature on EAC fractures consisting of isolated case reports. To the authors' best knowledge, this is the first study to use cone beam computed tomography to evaluate the EAC region. The aim of this study was to assess the prevalence of external auditory canal (EAC) fracture following maxillofacial trauma and to evaluate the association between EAC fracture and other maxillofacial fractures and the region of trauma. MATERIALS AND METHODS One hundred patients were prospectively evaluated over 6 months from February to August 2016. The patients were referred for CBCT regarding temporomandibular joint or condylar fractures following maxillofacial trauma. Two observers (both experienced radiologists) assessed the EAC and associated fractures in the maxillofacial region. RESULTS External auditory canal (EAC) fracture was confirmed in 32% of the patients. Of the EAC fractures, 68.75% and 31.25% were associated with mandibular fractures and non-mandibular fractures, respectively. Of the EAC fractures, 68.75% were single fractures and 31.25% of patients had multiple comminuted fractures. Significant association was observed on cross-tabulation of the fractured region and region of trauma with the presence of EAC fracture using chi-square test. CONCLUSION External auditory canal (EAC) fracture is associated with maxillofacial fractures with increased incidence in mandibular fractures compared to non-mandibular fractures.
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Affiliation(s)
- Ibrahim K Ali
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Kaustubh Sansare
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Freny R Karjodkar
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Prashant Salve
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Kavita Vanga
- Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, Maharashtra, India
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Intracranial Dislocation of the Mandibular Condyle: A Case Report and Literature Review. World Neurosurg 2016; 86:514.e1-11. [DOI: 10.1016/j.wneu.2015.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 09/04/2015] [Accepted: 09/05/2015] [Indexed: 11/18/2022]
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Dislocation of Mandibular Condyle Into Middle Cranial Fossa: Two Alternative Methods for Two Patients. J Oral Maxillofac Surg 2015; 73:1563.e1-16. [DOI: 10.1016/j.joms.2015.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/27/2015] [Accepted: 04/07/2015] [Indexed: 11/18/2022]
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Wood CP, Hunt CH, Bergen DC, Carlson ML, Diehn FE, Schwartz KM, McKenzie GA, Morreale RF, Lane JI. Tympanic plate fractures in temporal bone trauma: prevalence and associated injuries. AJNR Am J Neuroradiol 2014; 35:186-90. [PMID: 23828114 DOI: 10.3174/ajnr.a3609] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE 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. MATERIALS AND METHODS 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. RESULTS 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). CONCLUSIONS 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.
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Anterior Dislocation of the Intact Mandibular Condyle Caused by Fracture of the Articular Eminence: An Unusual Fracture of the Temporomandibular Joint Apparatus. J Oral Maxillofac Surg 2011; 69:1046-51. [DOI: 10.1016/j.joms.2010.02.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 02/26/2010] [Indexed: 11/19/2022]
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Temporal Bone Fractures: A Review for the Oral and Maxillofacial Surgeon. J Oral Maxillofac Surg 2008; 66:513-22. [DOI: 10.1016/j.joms.2007.08.039] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2006] [Revised: 07/30/2007] [Accepted: 08/30/2007] [Indexed: 11/20/2022]
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Magge SN, Chen HI, Heuer GG, Carrasco LR, Storm PB. Dislocation of the mandible into the middle cranial fossa. Case report. J Neurosurg 2007; 107:75-8. [PMID: 17644926 DOI: 10.3171/ped-07/07/075] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Dislocation of the mandibular condyle into the middle cranial fossa is a rare event due to anatomical and biomechanical factors. The authors report the case of a 12-year-old girl who presented with this condition after colliding with a classmate. One day after her injury, the patient demonstrated an inability to close her mouth completely, and she had minor tenderness to palpation anterior to the tragus, without neurological deficits. Imaging studies demonstrated a fractured glenoid fossa with intrusion of the mandible into the cranial cavity. Open reduction of the mandibular condyle was performed, and the glenoid fossa was reconstructed with a split-thickness bone graft and titanium screws. Several dural tears noted at the time of surgery were repaired primarily. Mandibular condyle dislocation into the middle cranial fossa is often misdiagnosed initially because of its low incidence and nonspecific symptoms. Computed tomography scanning is the most sensitive diagnostic study for detecting this injury. Closed reduction after induction of general anesthesia has been recommended in recently suffered injuries without neurological deficits, but this approach may overlook damage to intracranial structures. Surgical repair is recommended if neurological injury is suspected. Treatment options should be tailored to the individual factors of each case.
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Affiliation(s)
- Suresh N Magge
- Department of Neurosurgery, University of Pennsylvania Hospital of the University of Pennsylvania and Children's Hospital of Philadelphia, 19104, USA.
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Rosa VLM, Guimarães AS, Marie SKN. Intrusion of the mandibular condyle into the middle cranial fossa: case report and review of the literature. ACTA ACUST UNITED AC 2006; 102:e4-7. [PMID: 16831663 DOI: 10.1016/j.tripleo.2006.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2005] [Revised: 02/02/2006] [Accepted: 02/03/2006] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To describe a case of mandibular condyle intrusion into the middle cranial fossa in a young child and to systematically review the literature pertaining to this condition. STUDY DESIGN The diagnostic procedures comprised clinical examination, health history, and both magnetic resonance imaging and computerized tomography. A systematic review of the literature from PubMed, Medline, and Web of Science databases from 1960 to 2005 was made and a total of 55 cases in 51 references were found, of which 36 were described in detail. CONCLUSIONS Prompt diagnosis of mandibular condyle intrusion into the middle cranial fossa is essential to minimize complications. Advanced imaging modalities of computed tomography and magnetic resonance imaging are indicated.
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Affiliation(s)
- Vera L M Rosa
- Paulista School of Medicine, Federal University of São Paulo, SP, Brazil.
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Ohura N, Ichioka S, Sudo T, Nakagawa M, Kumaido K, Nakatsuka T. Dislocation of the Bilateral Mandibular Condyle Into the Middle Cranial Fossa: Review of the Literature and Clinical Experience. J Oral Maxillofac Surg 2006; 64:1165-72. [PMID: 16781355 DOI: 10.1016/j.joms.2006.03.043] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2004] [Indexed: 10/24/2022]
Affiliation(s)
- Norihiko Ohura
- Department of Plastic and Reconstructive Surgery, Saitama Medical School, Saitama, Japan.
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Miyauchi K, Sano K, Nagai M, Ogasawara T, Nakamura M, Kitagawa Y, Kawamura Y. Occult fractures of articular eminence and glenoid fossa presenting as temporomandibular disorder: a case report. ACTA ACUST UNITED AC 2006; 101:e101-5. [PMID: 16731372 DOI: 10.1016/j.tripleo.2005.10.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Revised: 09/14/2005] [Accepted: 10/17/2005] [Indexed: 11/28/2022]
Abstract
We report an unusual case of occult fractures of the articular eminence and glenoid fossa due to a previous traffic accident presenting as a temporomandibular disorder. A 24-year-old Japanese man was referred for trismus and pain in the right temporomandibular joint, and was suspected of having temporomandibular disorder. Although the magnetic resonance image did not show displacement of the articular disk, T2-weighted images revealed disruption of the cortical low-intensity line of the right articular eminence. On a computerized tomography (CT) scan, an isolated bone fragment of the right articular eminence was clearly seen, and fractures of the right glenoid fossa and articular eminence were noted. The patient was treated by instructing him not to open his mouth widely and to remain on a soft diet for 4 weeks. A CT examination performed 1 year after the treatment showed complete healing of the fracture in the right articular eminence and glenoid fossa.
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Affiliation(s)
- Kazuki Miyauchi
- Division of Dentistry and Oral Surgery, Department of Sensory and Locomotor Medicine, School of Medicine, University of Fukui, Matsuoka, Japan
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Harstall R, Gratz KW, Zwahlen RA. Mandibular Condyle Dislocation Into the Middle Cranial Fossa: A Case Report and Review of Literature. ACTA ACUST UNITED AC 2005; 59:1495-503. [PMID: 16394930 DOI: 10.1097/01.ta.0000199241.49446.80] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Roger Harstall
- Department of Orthopedic Surgery, University Hospital, Berne, Switzerland
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13
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Affiliation(s)
- A B Tay
- Department of Oral and Maxillofacial Surgery, National Dental Centre, Singapore, Singapore.
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Koretsch LJ, Brook AL, Kader A, Eisig SB. Traumatic dislocation of the mandibular condyle into the middle cranial fossa: report of a case, review of the literature, and a proposal management protocol. J Oral Maxillofac Surg 2001; 59:88-94. [PMID: 11152197 DOI: 10.1053/joms.2001.19301] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L J Koretsch
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, USA
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Psimopoulou M, Antoniades K, Magoudi D, Karakasis D. Tympanic plate fracture following mandibular trauma. Dentomaxillofac Radiol 1997; 26:344-6. [PMID: 9482010 DOI: 10.1038/sj.dmfr.4600297] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Bleeding from the external auditory canal following head trauma is not unusual. It can be caused by a posterior dislocation of the mandibular condyle associated with a fracture of the tympanic bone. Although posterior dislocation is uncommon, it is the second most frequent complication after antero-medial displacement of the condyle. We report four cases of tympanic plate fracture and present CT images demonstrating the range of injuries seen.
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Affiliation(s)
- M Psimopoulou
- Department of Oral & Maxillofacial Surgery, Dental School, Aristotle University of Thessaloniki, Greece
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Melugin MB, Indresano AT, Clemens SP. Glenoid fossa fracture and condylar penetration into the middle cranial fossa: report of a case and review of the literature. J Oral Maxillofac Surg 1997; 55:1342-7. [PMID: 9371133 DOI: 10.1016/s0278-2391(97)90199-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M B Melugin
- Department of Oral and Maxillofacial Surgery, Medical College of Wisconsin, Milwaukee 53226, USA
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17
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Dahlberg G, Magnusson M, Johansen CC, Rehncrona S. Fracture of the mandibular condyle causing meningeal bleeding. J Oral Maxillofac Surg 1995; 53:461-5. [PMID: 7699504 DOI: 10.1016/0278-2391(95)90725-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- G Dahlberg
- Department of Oral and Maxillofacial Surgery, University Hospital, Lund, Sweden
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18
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Antoniades K, Karakasis D, Daggilas A. Posterior dislocation of mandibular condyle into external auditory canal. A case report. Int J Oral Maxillofac Surg 1992; 21:212-4. [PMID: 1402049 DOI: 10.1016/s0901-5027(05)80221-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A case is reported of a 49-year-old edentulous patient who suffered a posterior dislocation of the right fractured mandibular condyle causing a fracture of the tympanic plate. This was associated with a right transverse fracture of the petrous bone and an intact tympanic membrane. Some of the problems related to this condition are discussed.
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Affiliation(s)
- K Antoniades
- Department of Maxillofacial Surgery, Dental School, Aristotle University of Thessaloniki, Greece
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Abstract
A case of compound fracture of the articular eminence is presented. The injury was sustained as a result of direct trauma which also caused a mandibular symphyseal fracture. Management comprised repositioning and support of the fractured fragment by means of sutures and the application of intermaxillary fixation. There was no long-term limitation of mandibular movement nor was there neurological or hearing deficit as a result of either injury or treatment.
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Affiliation(s)
- O Keith
- University Department of Oral Medicine, Bristol Dental Hospital and School, England
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Kent JN, Block MS, Homsy CA, Prewitt JM, Reid R. Experience with a polymer glenoid fossa prosthesis for partial or total temporomandibular joint reconstruction. J Oral Maxillofac Surg 1986; 44:520-33. [PMID: 3459837 DOI: 10.1016/s0278-2391(86)80092-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Glenoid fossa prostheses, alone or in combination with metallic condyles, were placed in 192 joints (127 patients) for temporomandibular joint reconstruction. Anatomic requirements, material characteristics, indications, and surgical technique are presented.
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Zachariades N. Glenoid fossa fracture and facial nerve palsy. INTERNATIONAL JOURNAL OF ORAL SURGERY 1985; 14:564-6. [PMID: 3936809 DOI: 10.1016/s0300-9785(85)80067-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Facial nerve palsy associated with traumatic injury in the temporomandibular joint area is a rather infrequent condition. Fracture of the glenoid fossa is a very rare condition, especially when it is not combined with displacement of the condyle in the middle cranial fossa. We are reporting the combination of these 2 conditions in a victim of a road traffic accident.
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Pepper L, Zide MF. Mandibular condyle fracture and dislocation into the middle cranial fossa. INTERNATIONAL JOURNAL OF ORAL SURGERY 1985; 14:278-83. [PMID: 3926673 DOI: 10.1016/s0300-9785(85)80040-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A case report is presented concerning a patient who sustained a condyle fracture with superior dislocation into the middle cranial fossa. Although relatively rare, other cases of central condylar dislocation have been presented and will be discussed and compared. Diagnosis has been a problem, and treatments have varied greatly for these cases. This is the first case on record, however, in which such a dislocation occurred in conjunction with a fracture of the condylar head. In the present case, the dura was covered with temporalis muscle and the glenoid fossa was covered using the fragments of the fractured condyle as an autogenous free bone graft.
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