Submandibular Approach to the Mandible (Cadaver)
Mark R. Rowan, MD, DDS; R. John Tannyhill, III, MD, DDS, FACS
Massachusetts General Hospital
The submandibular approach, also known as the Risdon approach, is a well-established extraoral surgical technique employed for the treatment of complex mandibular fractures and pathologies. Despite the increasing popularity of intraoral approaches for open reduction and internal fixation, the submandibular approach remains a valuable option in the arsenal of maxillofacial surgeons. This approach offers several advantages, including superior access and visualization of the mandibular body and angle, facilitating better manipulation and reduction of fracture fragments. Furthermore, the submandibular approach enables direct access to the submandibular gland, facilitating its management in cases of pathology or injury. By providing a comprehensive understanding of this technique through cadaveric exploration, this video aims to contribute to the training and education of maxillofacial surgeons, ultimately enhancing patient care and outcomes.
Open Reduction and Internal Fixation of Mandibular Body and Parasymphyseal Fractures with Maxillomandibular Fixation and Broken Tooth Extraction
Derek Sheen, MD1; Cheryl Yu, MD2; Sarah Debs, MD2; Peter Kwak, MD2; Nima Vahidi, MD3; Daniel Hawkins, DDS2; Thomas Lee, MD, FACS2
1University of Texas Southwestern Medical Center
2Virginia Commonwealth University Medical Center
3Upstate Medical Center
This is a case discussing a 21-year-old male who suffered from both non-comminuted mandibular parasymphyseal and body fractures as a result of a motor vehicle accident, requiring open reduction internal fixation (ORIF) without postoperative maxillomandibular fixation (MMF). The fracture was complicated by a broken tooth root, which required extraction.
After intraoperative MMF, ORIF was performed. The parasymphyseal fracture was plated using two locking four-hole 2-mm thick miniplates utilizing two locking screws on either side of the fracture with one plate along the alveolar surface (monocortical screw) and one along the basal surface (bicortical screw). For the right body fracture, a three-dimensional locking ladder plate was used via a transbuccal trocar approach for additional exposure needed for proper screw placement. Once the hardware was secured, the patient was taken out of MMF and restoration of premorbid occlusion was confirmed. Lastly, watertight mucosal closure was performed using absorbable sutures and Dermabond (cyanoacrylate adhesive).
Submandibular Approach to the Mandible (Cadaver)
Harvard Medical School
R. John Tannyhill, III, MD, DDS, FACS
Instructor in Oral and Maxillofacial Surgery
Massachusetts General Hospital
Harvard Medical School
Mark Rowan, MD, DDS
Resident Physician
Massachusetts General Hospital
Harvard Medical School
This case presents a cadaveric demonstration of the submandibular approach to the mandible, which can be used in cases involving osteomyelitis, the management of fractures, or pathology of the mandible or submandibular gland.
Parotid Dissection (Cadaver)
Duke University Medical Center
Ramon M Esclamado MD, MS
Professor, Department of Surgery
Chief, Division of Head and Neck Surgery & Communication Sciences
Dr. Esclamado instructs a cadaver lab at Duke University Hospital to assist resident training on a standard parotid dissection. The approach should be adjusted depending on tumor malignancy, as Dr. Esclamado explains.
The New Gold Standard for Surgical Videos
