Arterial Vascularization of the Mandibular Condyle and Fractures of the Condyle

Background: Despite substantial displacements, fractures of the mandibular condyle rarely lead to necrosis. This illustrates the negligible role of the inferior alveolar artery in intraosseous supply to the condyle, and led to this systematization of its arterial vascularization. Methods: Forty-two temporomandibular joints (TMJ) from non-embalmed cadaveric specimens were studied following injection of latex (32 TMJ) or India ink (10 TMJ). Results: The intraosseous branches of the inferior alveolar artery that lead to the condyle were inconstant and often rudimentary. In this study, the arteries that consistently led to the condyle were: the superficial temporal artery, the deep posterior temporal artery, and arterial branches leading to the lateral pterygoid muscle emanating directly from the maxillary artery. These arteries, along with the transverse facial artery and the masseteric artery (when they participated in condoyle vascularization) formed a quadrangle around the mandibular condyle. Following India ink injection, the pterygoid muscle was the most strongly colored muscle, thus indicating substantial vascularization. Conclusions: While there is a lack of consensus in the literature regarding the constancy and proportions of the arteries participating in vascularization of the condyle, the superficial temporal artery, the maxillary arterial branches leading to the lateral pterygoid muscle, and the deep posterior temporal artery were constant in this study. This study shows the important role of the lateral pterygoid in the vascularization of the condyle. In case of a fracture with substantial displacement, the vascularization emanating from the superficial temporal artery and the lower alveolar artery is ruptured or compromised. Financial Disclosure Statement: The author has no funding to declare Acknowledgments: The author would like to thank the administrative and technical staff of the anatomy laboratory, URDIA and ANCRE, from Paris Descartes University for their help. The author would also like to thank the donors. Corresponding author: Gaoussou Toure, MD, PhD, FEBOMFS , Centre Hospitalier Intercommunal Lucie & Raymond Aubrac, 40 allée de la source, 94195 Villeneuve Saint-Georges Cedex, France; Tel: +33 143 862 247; +33 143 862 128, Email: gaoussou.toure@chiv.fr; gtoure1@gmail.com ©2018American Society of Plastic Surgeons

http://ift.tt/2Do5q4q