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197318

A Modified Submandibular Approach - Assessment of Outcome

Article

Last updated: 22 Jan 2023

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Abstract

The submandibular approach has been an integral tool in facial surgery since 1934. The technique is indicated in different clinical scenarios. This approach is governed by two key determinants; namely the skin tension lines and the course of the marginal mandibular branch. Aim of study: this study suggests that moving the incision further into the neck while respecting the course of the facial nerve would help achieving both optimal esthetic outcome as well as less nerve injuries. Materials and methods: eight patients requiring facial surgery, where the submandibular approach was indicated, were recruited and the modified submandibular incision was applied. The function of the facial nerve was followed up for six months using the Houseman-Brackman test. The esthetic result was assessed by two panels; consultant maxillofacial surgeons, and lay persons mainly concerned with the esthetics. The panel reviewed the cases through a power point presentation. A questionnaire customized to each panel's expertise was then provided. Results: Surgeons grading intra-class correlation coefficient (ICC) showed that there was an excellent agreement in questions 1, 4, 5 and 7 (ICC=0.672, ICC=0.647, ICC=0.753 and ICC=0.679 respectively). The 5 different maxillofacial surgeons had excellent agreement on that the incision utilized accurately facilitated accessibility, good healing and pleasant esthetic outcome. Regarding lay persons grading, intra-class correlation coefficient (ICC) showed that there was an almost perfect inter-observer agreement on the success of the technique esthetically (ICC=0.826 and 0.838 respectively).Conclusion: the modified submandibular approach provided better aesthetic results and lower risk of facial nerve injury.

DOI

10.21608/edj.2021.87377.1721

Keywords

Submandibular approach, Risdon incision, Modified submandibular approach

Authors

First Name

Amr

Last Name

Ghanem

MiddleName

-

Affiliation

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Cairo, Egypt

Email

amrghanem@asfd.asu.edu.eg

City

Cairo

Orcid

-

First Name

Abd al Ghany

Last Name

Farag

MiddleName

-

Affiliation

Specialist OMFS, Ministry of health Hospitals, Egypt

Email

abdelghanyfarag@dent.asu.edu.eg

City

-

Orcid

-

First Name

Mohamed

Last Name

Mosleh

MiddleName

-

Affiliation

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Beni- Suef University, Beni Suef, Egypt

Email

mohamed_mosleh7@hotmail.com

City

-

Orcid

0000-0001-9218-8466

Volume

67

Article Issue

4

Related Issue

27924

Issue Date

2021-10-01

Receive Date

2021-07-25

Publish Date

2021-10-01

Page Start

3,051

Page End

3,060

Print ISSN

0070-9484

Online ISSN

2090-2360

Link

https://edj.journals.ekb.eg/article_197318.html

Detail API

https://edj.journals.ekb.eg/service?article_code=197318

Order

11

Type

Original Article

Type Code

254

Publication Type

Journal

Publication Title

Egyptian Dental Journal

Publication Link

https://edj.journals.ekb.eg/

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Details

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Article

Created At

22 Jan 2023