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- 1. SURGICAL APPROACHES TO THE CONDYLE Dr.S.Shanmugasundaram READER SRM DENTAL COLLEGE, RAMAPURAM
- 2. SURGICAL ANATOMY Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari FACIAL NERVE – 2 TRUNKS RETROMANDIBULAR VEIN GREATER AURICULAR NERVE PAROTID GLAND
- 3. LOCATING THE FACIAL NERVE A modified pre-auricular approach to the TMJ and malar arch, BJOMS 17(1979), 91-103. Postglenoid tubercle Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 4. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 5. VARIOUS APPROACHES RETROMANDIBULAR PREAURICULAR RHYTIDECTOMY ENDAURAL SUBMANDIBULAR INTRAORAL Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 6. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari RETROMANDIBULAR APPROACH HINDS & GIROTTI 1958
- 7. Courtesy :Edward Ellis Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 8. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 9. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 10. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 11. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 12. VESNAVER – PERIAURICULAR APPROACH 2005 Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 13. RETROMANDIBULAR WITH MODIFIED TRANSPAROTID APPROACH Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 14. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 15. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 16. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 17. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 18. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 19. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 20. PREAURICULAR APPROACH History – Early description by Blair – Inverted L incision Dingman and Grabb modified – Making the angle between vertical and superior portions of incision more obtuse and rounding the angle of intersection. Lempert and Shambaugh modified – Carrying the incision to varying degrees behind the tragus and into EAC , creating Endaural incision. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 21. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari Courtesy : Edward Ellis
- 22. INCISIONS Blair’s inverted hockey stick Thoma’s Angulated Incision Dingman’s Incision Endaural Incision Dingman’s incision Endauralincison Popowich and Crane incision Post ramal Posterior Auricular Incision Popowich & Crane Incision Posterior auricular Submandibular Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 23. THOMA’S ANGULATED INCISION Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 24. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 25. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 26. AL-KAYAT BRAMLEY A modified pre-auricular approach to the TMJ and malar arch, BJOMS 17(1979), 91-103. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 27. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 28. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 29. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 30. MODIFIED ENDAURAL Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 31. RHYTIDECTOMY APPROACH Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 32. CERVICO FASCIAL RHYTIDECTOMY Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 33. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 34. LAZY S INCISION Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 35. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 36. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 37. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 38. SUBMANDIBULAR INCISION Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 39. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari Courtesy: Edward Ellis
- 40. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 41. INTRAORAL APPROACH Steinhauser (1964) was the first to report a successful osteosynthesis following intraoral approach. Since then it has been used by Pape et al(1980), Horch et al (1983), Kitayama (1989) It requires an incision through the vestibular mucosa along the anterior edge of the ascending ramus and the periosteum and masseter are reflected. Miniplates are fixed by means of a transbuccaltrocar or an angled screwdriver. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 42. Intraoral Incision Endoscopic Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 43. ENDOSCOPIC APPROACH Equipment– 30° angle 4mm diameter endoscope ( Karl Storz , Tuttlingen , Germany ) Xenon light source Suction and Irrigation device Contra-angled handpiece Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 44. COMPLICATIONS Nerve injury -temporary -permanent Sialocele Infection Hematoma Bad scar. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 45. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 46. POINTS TO REMEMBER PREAURICULAR APPROACH : High condylar fractures Incision within 8mm Temporal extension Facial nerve identification RETROMANDIBULAR APPROACH : Subcondylar fractures Modified transparotid dissection Horizontal mattress suture. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 47. ACKNOWLEDGEMENT FACULTY OF THE DEPT OF OMFS, SRMDC, RAMAPURAM, CHENNAI. Dr. GUNASEELAN RAJAN, DIRECTOR, RAJAN DENTAL INSTITUTE, MYLAPORE, CHENNAI. BONE & JOINT HOSPITAL, ANNA NAGAR, CHENNAI. Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari
- 48. THANK YOU Dr.S.Shanmugasundaram, 15th AOMSI, Kanyakumari