Tratamento cirúrgico de fratura bilateral de côndilo mandibular: relato de caso

Abstract

Mandibular fractures are facial injuries most common in the maxillofacial region affecting primarily the condyle, representing 25 to 35% of mandibular fractures. The etiology of condylar fractures is diverse, including automobile accidents, work accidents, falls, interpersonal violence, and trauma. Fractures in the condyle, or the mandibular head, are the most common and controversial regarding treatment choice. This study aims to report a clinical case of surgical treatment of bilateral mandibular condylar fracture due to a fall from own height. The clinical examination showed bilateral preauricular edema, mouth-opening limitation, and right and left laterality with pain complaints in all mandibular movements. The tomographic analysis demonstrated bilateral subcondylar and right zygoma body fractures. The zygomatic bone fracture did not present esthetic or functional repercussions; therefore, conservative treatment was selected for this fracture. However, considering the degree of displacement of condylar fractures, the anatomic reduction of the ramus height, and the lack of occlusion, the surgical treatment was indicated to reduce and fixate both fractured condyles. The immediate postoperative showed zygomatic ramus paralysis of the left facial nerve and suture dehiscence with purulent drainage bilaterally associated with saliva in the retromandibular incision region. The complications were treated clinically with a satisfactory outcome. Despite the controversial surgical approach for treating condylar fractures, it allows reducing the fractured stumps by reestablishing posterior facial height, promoting a faster return to daily activities.