Correlations between posturographic findings and symptoms in subjects with fractures of the condylar head of the mandible

• Published in: European archives of oto-rhino-laryngology 2009-04, Vol.266 (4), p.565-570
• Main Authors: Faralli, Mario M., Calenti, Claudio C., Ibba, Maria Cristina M., Ricci, Gianpietro G., Frenguelli, Antonio A.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Female; Head and Neck Surgery; Humans; Injuries of the limb. Injuries of the spine; Male; Mandibular Condyle - injuries; Mandibular Fractures - complications; Mandibular Fractures - physiopathology; Medical sciences; Medicine; Medicine & Public Health; Miscellaneous; Neurosurgery; Otorhinolaryngology; Otorhinolaryngology. Stomatology; Postural Balance - physiology; Prospective Studies; Risk Factors; Sensation Disorders - etiology; Sensation Disorders - physiopathology; Temporomandibular Joint Disorders - etiology; Temporomandibular Joint Disorders - physiopathology; Traumas. Diseases due to physical agents; Vestibular Function Tests
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-008-0802-x

Our study examined the posture of 15 patients who had sustained a simple unilateral or bilateral fracture of the condylar head of the mandible as a result of sports or traffic accidents. Following preliminary testing of vestibular function, the patients underwent balance testing: Romberg test with eyes closed (EC), Romberg EC and bite test (ECBT), EC and head retroflexed (ECR). The study parameters were: surface ( S ) of the statokinesigram, stomatognathic influence index related to S (SSI), and postural oscillations on the frontal plane (X). In keeping with the literature, we felt that the following pattern in static balance suggested a posture destabilised by the stomatognathic system: SSI values of less than 60, reduction of S in the transition from EC to ECR, pathological increase of postural oscillations on the X plane. The study was completed by obtaining a list of new symptoms reported by the patients (altered bite, fullness, tinnitus, pain, loss of balance). The most significant patterns were observed in patients with vestibular dysfunctions and neck pain. It seems that a fracture of the condylar head can affect postural behaviour, although proprioceptive changes alone are not enough to cause true loss of balance and there must be concomitant vestibular dysfunction. The stabilometric pattern is not conditioned by the extent of the trauma or the related treatment. In terms of proprioceptive elements, the presence of muscle pain seems to point to cervical muscle tension as the main culprit in the onset of posttraumatic instability.