Superolateral Dislocation of the Mandibular Condyle Not Associated With Fracture: A Case Report

Background  

Superolateral dislocation is rarely encountered in clinical practice. It is usually associated with fracture of the contralateral mandibular body or zygoma. The occurance of type II superolateral dislocation of the condyle without associated fracture is very rare and only a few cases are reported in literature.     

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

Background and Purpose

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.

Patients and Method

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.

Conclusion

This article intends to provide information regarding the possible biomechanics and management of bilateral superolateral dislocation of mandibular condyles associated with symphysis fracture.

     

Superolateral Dislocation of the Mandibular Condyle: A Series of Seven Cases

Introduction

Anterior and anteromedial dislocations of the mandibular condyle are seen frequently in mandibular fractures. Less frequent are dislocations of the condylar head in the lateral, medial and posterior direction whereas superior dislocation into the middle cranial fossa is rare. We report a series of seven cases encountered over the years, which, incidentally, is the largest case series reported till date with lateral and superolateral dislocation of the condyle after a traumatic injury.

Materials and method

In all cases but one, the condyle was reduced by manual manipulation with the patient in general anaesthesia. In all cases but one there was simultaneous fracture in the mandibular symphyseal region. The associated fractures were reduced and fixed with bone plates and screws.

Results

Patients were generally free from any long term complications of injury or surgery except for facial nerve paresis of a transient nature in one case.

Conclusion

To our knowledge, this clinical series presents the first reported case of superolateral dislocation which required open reduction. The etiology and mechanism of dislocation has been discussed along with a brief review of the literature.

Electronic supplementary material

The online version of this article (doi:10.1007/s12663-015-0770-9) contains supplementary material, which is available to authorized users.     

Unilateral Trifid Mandibular Condyle: A Case Report

Abstract

Trifid mandibular condyle is an exceptionally rare entity, diagnosed accidentally on radiographic examination. Its etiology is controversial. Dental professionals should have knowledge of this anatomic abnormality and of the problems caused by it in normal function, as well as appropriate treatment modalities. In the literature, only three such cases have been reported. The current case report (the fourth reported) is of a unilateral trifid condyle reported in a 37-year-old woman seeking treatment for a missing tooth. A panoramic radiograph accidentally revealed a discrete modification of the right mandibular condyle. Computed tomography (CT) with 3-D construction was done to confirm the diagnosis.     

下颌骨髁突骨软骨瘤——附1例报告

<正>骨软骨瘤(osteochondroma),又名骨软骨外生骨疣,是一种良性软骨增殖性疾病,借广基或蒂与正常密质骨相连,表面覆盖软骨组织帽状结构。可单发或多发,后者为常染色体显性遗传性疾病。好发于长管状骨干骺端表面,发生于颌骨者较少,多位于下颌髁突及喙突。本文结合收治的1例髁突骨软骨瘤,及1994年至今的国内外相关文献,讨论该病的诊断和治疗。     

Unusual Superolateral Dislocation of Bilateral Mandibular Condyles

We describe a case of maxillofacial trauma in a paediatric patient in which the left mandibular condyle was superolaterally displaced into the temporal fossa, medial to the zygomatic arch which was intact and the right condyle was also displaced similarly but the zygomatic arch was also fractured on this side. Also, there was an associated mandibular symphyseal fracture.     

Analysis of Patterns and Treatment Strategies for Mandibular Condyle Fractures: Review of 175 Condyle Fractures with Review of Literature

This study aims to evaluate incidence, patterns and epidemiology of mandibular condylar fractures (MCF) to propose a treatment strategy for managing MCF and analyze the factors which influence the outcome. One hundred and seventy-five MCF’s were evaluated over a four year period and their pattern was recorded in terms of displacement, level of fracture, age of incidence and dental occlusion. Of the 2,718 facial bone fractures, MCF incidence was the third most common at 18.39 %. Of 175 MCF 58.8 % were unilateral and 41.12 % were bilateral. 67 % of bilateral fractures and 43.8 % of unilateral fractures were associated with midline symphysis and contralateral parasymphysis fractures respectively. Most of the MCF was seen in the age group of above 16 years and 50 % of them were at subcondylar level (below the neck of the condyle). Majority of MCF sustained due to inter personal violence were undisplaced (72.7 %) and contrary to this majority of MCF sustained during road traffic accident were displaced. 62.9 % of total fractures required open reduction and rigid fixation and 37.1 % were managed with closed reduction. 80 % of MCF managed with closed reduction were in the age group of below 16 years. From this study it can be concluded that the treatment algorithm proposed for managing MCF is reliable and easy to adopt. We observed that absolute indication for open reduction of MCF is inability to achieve satisfactory occlusion by closed method and absolute contraindication for open reduction is condylar head fracture irrespective of the age of the patient.     

下颌骨髁突颅内脱位的研究进展

下颌骨髁突前脱位较为常见,而颅内脱位(上脱位)却非常少见.迄今为止,关于髁突颅内脱位,国内文献鲜有报道;而Pubmed所报道的此类患者仅仅数十例.虽然此类疾病较为罕见,其治疗却十分具有挑战性.本研究回顾以往文献,对髁突颅内脱位的发病机制、临床表现、诊断和治疗做一简要综述,为临床诊治提供参考.     

颞下间隙感染致髁状突破坏的病例报告

颌面部间隙感染目前仍然是口腔颌面外科的常见多发病。随着抗生素的普遍使用,口腔颌面间隙感染发病率呈上升趋势。由于颌面部特殊的解剖结构,颌面间隙感染的并发症较多且危险。预防颌面感染并发症成为治疗颌面间隙感染的治疗的关键。颌面间隙感染并发髁状突破坏在国内外鲜有报道,本文将报道1例颞下间隙感染并发髁状突破坏的病例,并对国内外文献进行回顾。     

Chondroblastoma of the Temporal Bone Involving the Temporomandibular Joint,Mandibular Condyle,and Middle Cranial Fossa: Case Report and Review of the Literature

Abstract

Chondroblastoma is a highly destructive tumor, derived from immature cartilage cells, typically occurring in epiphyses of the long bones of adolescents and young adults. Those occurring in the temporal bone and TMJ area are likely to mimic TMJ symptoms. This report describes a unique case in which a chondroblastoma resulted in extensive destruction of the temporal bone, temporomandibular joint, mandibular condyle, and cranial base, including gross intracranial and extracranial involvement. With appropriate surgical management, the outcome for patients with chondroblastoma of the temporomandibular region is quite favorable. This case brings the total reported chondroblastomas to 59 in the temporal bone and eight in the mandibular condyle as of the date of submission of this article for publication.     

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

BackgroundDislocation 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.PurposeThis case report brings forth a unique case of bilateral posterior condylar dislocation in an edentulous patient who reported after 4 weeks of traumatic injury.MethodThe 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.ResultsThe patient was maintained on long-term follow-up for up to one year with no reported recurrence or reduction in mouth opening.ConclusionThis 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.