Dislocation of Mandibular Condyle Into Middle Cranial Fossa: Two Alternative Methods for Two Patients

Superior Dislocation of the Mandibular Condyle into the Middle Cranial Fossa: A Comprehensive Review of the Literature

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.

Dislocation of the mandibular condyle into the middle cranial fossa. A case of temporomandibular joint arthroplasty with resorbable fixation system and temporalis myofascial flap: systematic review and meta-analysis

The aims of the present study were to comprehensively assess all the published cases on dislocation of the mandibular condyle into the middle cranial fossa (DMCCF) in the literature in English and describe the clinical, imaging, and therapeutic variables for this condition. An electronic search was undertaken in March 2020 using PubMed/MEDLINE, Web of Science, ScienceDirect, Springer, and Scopus databases. Eligibility criteria included publications with sufficient information to confirm the diagnosis. In addition, we have presented the case report of a 13-year-old boy with DMCCF, who was treated with craniectomy, arthroplasty, and reconstruction with a resorbable osteosynthesis material obtaining favourable and functional results. A total of 72 cases reported in English, including ours, were analysed and discussed. Most of the patients were female (n= 49) with a mean (range) age of 23.4 (5-72) years, the most affected condyle was the right (n= 42), the main aetiology was a motor vehicle accident, and half of the patients had intracranial lesions. Open treatment was performed in the majority with condylar surgery that included condylotomy and condylectomy. Temporomandibular joint arthroplasty was performed with bone, osteosynthesis material, and flap rotation. Timely treatment before four weeks was performed in most of the cases and, despite this, the persistence of the deviation was observed in more than a third of cases, with functional and neurosensorial sequelae. The present study allows an update of the characteristics of DMCCF and gives a current vision of how to manage this rare and complex fracture.

Anatomical Examination of Mandibular Condyle Protrusion Into the Middle Cranial Fossa

Trauma to the mandible can occasionally be a life-threatening event. Although extremely rare with only 56 reported patients in the English language, fracture of the floor of the middle cranial fossa with protrusion of the mandibular condyle into the middle cranial fossa was first reported in 1963 by Dingman. The authors review the anatomy of the temporomandibular joint in relation to the middle cranial fossa and demonstrate the possible complications due to condylar intrusion with anatomical dissection.