6.26.24
Quick Review #158 - #surgery #surgeon #doctorgallagher #oralsurgery #oralsurgeon #omfs #dentist #dentistry #dental #risdon #mandible
The Risdon approach is a surgical technique used in oral and maxillofacial surgery, particularly for accessing the mandible in the region of the angle and ramus. This approach is named after Walter G. Risdon, who described it in the early 20th century. It involves making an incision below the lower border of the mandible, usually along a natural skin crease, to minimize visible scarring:
Indications:
1. Mandibular Fractures: Accessing and treating fractures of the mandibular angle and ramus.
2. Osteotomies: Performing orthognathic surgery procedures, such as bilateral sagittal split osteotomies.
3. Pathologic Conditions: Accessing and removing cysts, tumors, or other pathologies located in the mandibular ramus and angle.
4. Reconstructive Procedures: Bone grafting or reconstructive surgery involving the mandible.
Advantages:
1. Excellent Access: Provides good visibility and access to the mandibular angle and ramus.
2. Minimal Visible Scarring: Incision is made along a natural skin crease, reducing the likelihood of noticeable scarring.
3. Protection of Facial Nerve: The approach allows careful dissection around the marginal mandibular branch of the facial nerve, minimizing the risk of nerve injury.
4. Reduced Risk of Infection: Being a submandibular approach, it avoids the oral cavity, reducing the risk of intraoral contamination and infection.
Disadvantages:
1. Risk of Nerve Injury: Despite careful dissection, there is still a risk of injury to the marginal mandibular branch of the facial nerve, which can result in temporary or permanent weakness of the lower lip.
2. Limited Access to Certain Areas: While excellent for the angle and ramus, it may not provide sufficient access for procedures involving the body or symphysis of the mandible.
3. Postoperative Swelling and Bruising: As with any surgical procedure, there is a risk of significant swelling and bruising in the postoperative period.
4. Scarring: Although minimized, there is still a potential for visible scarring, especially if healing is not optimal or if the incision is not placed precisely within a skin crease.
References:
1. Bartlett, S., Ehrenfeld, M., Mast, G., & Sugar, A. (n.d.). Submandibular approach. AO Surgery Reference. Retrieved June 17, 2024, from https://lnkd.in/eKhShyi2.
2. Miloro, M., Ghali, G. E., Larsen, P. E., & Waite, P. D. (Eds.). (2012). Peterson’s principles of oral and maxillofacial surgery (4th ed.). PMPH-USA.
3. Ellis, E., Zide, M. F., & Obwegeser, H. L. (Eds.). (1999). Surgical approaches to the facial skeleton. Lippincott Williams & Wilkins.
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