The Role of a Deep Neuromuscular Block in the Treatment of Mandibular Subcondylar Fractures

Mandibular fractures are the third most frequent maxillo-facial fractures, and the subcondylar region is their most frequent site. This study evaluated the advantages of deep neuromuscular block during endoscopic surgery for subcondylar fractures. Twenty-five patients affected by subcondylar fractures were enrolled and divided into two groups: group A received an intraoperative booster of curare during the surgical procedure, group B underwent surgery without it. All patients were treated successfully by endoscope-assisted transoral approach. The analysis of the time required for surgery showed a reduction in group A compared to group B: the mean time for surgery in group B was 170 minutes for displacement between 0° and 45°, and 230 minutes for 45° to 90°; in group A the mean time was 117.5 and 147.5 minutes respectively. In conclusion, deep neuromuscular block seems to improve the surgical conditions in patients undergoing subcondylar endoscopic-assisted surgery; further studies are needed to better define this surgical protocol.