Which type of mandibular fracture presents the greatest risk of airway obstruction?

The fracture type that presents the greatest risk of airway obstruction is a bilateral angle fracture. This specific type of fracture can lead to significant displacement and elevation of the mandibular body, potentially compromising the airway. The angle region of the mandible is associated with the posterior aspect of the jaw, where the muscles responsible for mastication are attached. When both angles are fractured, there is a high likelihood of muscle dysfunction and loss of structural integrity, which can lead to displacement of the mandible and cause the tongue to fall back, obstructing the airway.

In cases of bilateral angle fractures, swelling and hematoma formation can further exacerbate the situation, putting additional pressure on the airway structures. Moreover, the more posterior location of these fractures can contribute to a functional impairment of airway patency compared to more anterior fractures.

Other types of fractures listed may pose risk as well, but they typically have less direct involvement with the potential airway compromise than bilateral angle fractures. For example, bilateral parasymphysis fractures typically do not involve the posterior mandible and are more anteriorly located, while unilateral angle fractures and symphyseal fractures pose different mechanical risks but are less likely to cause significant airway issues compared to bilateral angle fractures.