Application Of Self-made Transbuccal Pipe For Fractured Mandible Angle And Mandible Ramus

Objective: To discuss application of self-made transbuccal pipe for fractured mandible angle and mandible ramus and to evaluated the effects of this approach aiming to provide safe and cheap treatment for patients with angle and ramus fractures. Methods: Twelve cases with mandibular angle and mandibular ramus fractures were treated by screwed miniplates placed through a transbuccal incision with self-made transbuccal pipe from October 2005 to December 2006. After exposing the bone break, to divide bluntly through subcutaneous tissue to the skin from the oral incision, cut open 0.5cm skins, then the self-made transbuccal pipe was send the the bone break from skin incision to reposite mandibular angle and mandibular ramus fractures with a titanium mini-plate in the oral incision. 18 cases treated through extraoral approach were treated as the controls. Results: Only two patients treated by intraoral approach and three by extraoral approach required a period of maxillamandibular fixation because of fracture fragments mobile. Anatomic reduction was achieved in all cases, without damage to facial nerve and major auricular nerve. One patient treated by extraoral approach happened salivary fistula. There were good temporomandibular joint function and no bony resorption after surgery. All cases regained their natural occlusion. Conclusions: Intraoral approach not only could avoid large facial scars and facial nerve injury, but also allow visualization of the occlusion during the procedure. As more and more consideration is taken to cosmetology, the intraoral approach is a reliable surgical selection for fractures of the angle and ramus of mandible, without leaving extensive visible scars or damaging facial nerve.