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Mandibular subluxation stabilized by mouthpiece for distal internal carotid artery exposure in carotid endarterectomy  Masanori Yoshino, MD, Hiroshi Fukumoto,

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Presentation on theme: "Mandibular subluxation stabilized by mouthpiece for distal internal carotid artery exposure in carotid endarterectomy  Masanori Yoshino, MD, Hiroshi Fukumoto,"— Presentation transcript:

1 Mandibular subluxation stabilized by mouthpiece for distal internal carotid artery exposure in carotid endarterectomy  Masanori Yoshino, MD, Hiroshi Fukumoto, DD, PhD, Tohru Mizutani, MD, PhD, Ryuji Yuyama, MD, Takayuki Hara, MD, PhD  Journal of Vascular Surgery  Volume 52, Issue 5, Pages (November 2010) DOI: /j.jvs Copyright © 2010 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Photographs show the process of making the custom-made mouthpiece. A, The mandible is mobilized anteriorly and laterally to the subluxated position. B, Model of the patient's teeth is made, and from which the final mold is created. C, The mandible has been subluxated and stabilized with the mouthpiece. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

3 Fig 2 Photograph shows the intraoperative anatomy after the carotid artery is dissected. The occipital artery (arrowhead) and hypoglossal nerve (arrow) are clearly identified. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Illustrations show anterior and lateral views of the operative technique. A, The mandible is mobilized contralaterally and stabilized with the mouthpiece. B, The normal position of the mandible is shown without subluxation. C, The mandible is mobilized anteriorly to the subluxated position. Mandibular subluxation stabilized by the mouthpiece can provide additional exposure. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Preoperative three-dimensional computed tomography angiography simulations. A, Normal location of the temporomandibular joint is shown without subluxation. B, Subluxated position of the temporomandibular joint stabilized with the mouthpiece. The mandible is stabilized in the subluxated position, but is not stabilized in the dislocated position. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

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