Mandibular condyle dislocation into the middle cranial fossa: First report of CAS-guided surgical management

Traumatic mandibular condylar fractures are the most common mandibular fractures in maxillofacial surgery. Approximately 42 % of facial skeletal fractures involve the mandible, and of these, 34 % involve the mandibular condyle. Normally, due to its anatomical structure, the mandibular condyle fractures upon impact and dislocates anteriorly and/or medially. This mechanism preserves the integrity of the cranial base. In rare cases, a fracture of the glenoid fossa and an intrusion of the condylar head at the level of the middle cranial fossa occurs. This represents a serious complication, in which ensuring patient survival is the primary goal of the treatment, possibly followed by the restoration of joint functionality and the prevention of ankylosis. We present the first documented application of computer-assisted surgery (CAS) aided by in-house 3D printing for the management of this condition, enabling precise preoperative planning, enhanced patient counseling, and successful surgical outcomes. Stable occlusion and mandibular mobility were achieved and preserved after 3 months, with the support of re-adapted prostheses used for intermaxillary fixation and functional rehabilitation. This novel approach underscores the potential of CAS and 3D printing to revolutionize the preoperative and surgical approach of rare and complex cranio-maxillofacial cases.