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Cervico-stylo-mandibular complex fracture: a critical review of literature along with a protocol to recognize and proposal of a new classification

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2019, v.45 no.6, pp.302-308
https://doi.org/10.5125/jkaoms.2019.45.6.302
Nanda Kishore Donepudi (Bapuji Dental College & Hospital)
Vinayak Gourish Naik (Bapuji Dental College & Hospital)
Kirthi Kumar Rai (Bapuji Dental College & Hospital)

Abstract

Fractures of the styloid process of the temporal bone may occur with or without an obvious relation to trauma. The incidence of either isolated styloid process fracture or in combination with mandibular fractures is rare, and such occurrences are often misdiagnosed or neglected. A fractured styloid when displaced may impinge on adjacent vital structures, leading to neurological or vascular symptoms that vary according to the anatomical structure compressed. Styloid process fractures associated with atlas/C1 fractures have also been rarely reported in the literature. In this review of literature, the majority of patients was treated conservatively, as few demonstrated the necessity of surgical intervention. There is a definitive need for a protocol to recognize and classify styloid fractures to plan for further treatment. The aim of this review was to achieve a comprehensive understanding of all types of styloid fractures, determine the clinical severity of symptoms, and to consider management and prognosis. In addition, a new classification of cervico-stylo-mandibular fractures is proposed based on important evidence in the literature regarding clinical and radiographic factors that might influence the treatment and prognosis of such fractures.

keywords
Styloid process fractures, Cervico-stylo-mandibular fractures, Classification

Journal of the Korean Association of Oral and Maxillofacial Surgeons