Fractures of the “Stylo-mandibular Complex” - a prospective study proposing a classification and clinical protocol

Publication date: Available online 22 February 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Elavenil Panneerselvam, Sasikala Balasubramaniam, Aditi Rajendra Sharma, Pathumai Murugadoss, Saravanan Chellappazham, Krishnakumar Raja VB
PurposeMandibular trauma can result in "stylomandibular complex" (SMC) fractures with clinical symptoms including glossopharyngeal neuralgia, globus pharyngeus, otalgia, dysphonia, etc. The fracture of styloid process is noteworthy because of its proximity to numerous vital structures. The study objectives were to (1) determine the incidence of SMC fractures and develop a clinical grading, and (2) institute and assess a treatment protocol.Materials and MethodsThe prospective clinical trial involved 206 patients with mandibular trauma based on a set of inclusion and exclusion criteria. On the basis of clinical presentation of symptoms, patients were categorised as mild, moderate and severe, and radiographically as Type 1, 2 and 3. Patients were treated by an institutional protocol and outcome was evaluated. A grading system was developed by correlating clinical features to Imaging. Data was analysed using SPSS v.22. Descriptive and Analytical statistics were computed.ResultsThe incidence of styloid fracture was 11.17% .The most concomitant mandibular fractures were condyle (13) and angle (7). Dysphagia and restricted mouth opening were the most common symptoms. Distribution of radiographic types 1, 2 and 3 were 26.1, 69.6 , and 4.3% respectively. A significant correlation (P<0.001) was found between clinical symptoms and radiographic types using Fishers Exact Test.ConclusionThe study proposes a clinical grading of SMC fractures and a symptom based management algorithm.



http://ift.tt/2sIidtK