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Retromandibular transparotid approach for subcondylar mandibular fracture: A retrospective study
Author(s) -
Koirala Ujjwal,
Subedi Sushil
Publication year - 2021
Publication title -
dental traumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 81
eISSN - 1600-9657
pISSN - 1600-4469
DOI - 10.1111/edt.12626
Subject(s) - medicine , condyle , facial nerve , internal fixation , palsy , temporomandibular joint , retrospective cohort study , dentistry , malocclusion , reduction (mathematics) , surgery , pathology , alternative medicine , geometry , mathematics
The retromandibular transparotid approach provides the shortest and the most direct access to mandibular sub‐condylar fractures. However, this approach is less preferred due to the fear of facial nerve injury. The aim of this study was to evaluate the safety and morbidity of the retromandibular transparotid approach for open reduction and internal fixation of sub‐condylar mandibular fractures. Methods A retrospective cohort study of 29 patients with 35 sub‐condylar mandibular fractures who underwent open reduction and internal fixation through the retromandibular transparotid approach was conducted. The primary study variable was facial nerve palsy, whereas the secondary variables were infection, sialocele, salivary fistula, stability of the fractured segments, post‐operative malocclusion, Frey's syndrome, and unesthetic scar. All patients were followed up for 6 months. Predictor variables included age, gender, side, location, displacement, etiology, concomitant maxillofacial fractures, and healing status. Fisher's exact test was calculated to find the association between primary variables and predictor variables. Result Out of 35 sub‐condylar fractures (29 patients; 23 male, 6 female), four (11.42%) developed transient facial nerve palsy. Fractures at the condylar neck level ( P = .045) and with displacement ( P = .026) were significantly associated with the development of facial nerve palsy. Four patients (13.8%) developed slight malocclusion, two had surgical site infections, two developed sialoceles, and one had a salivary fistula. Conclusion The retromandibular transparotid approach is safe and effective with rare major complications in the management of sub‐condylar fractures of the mandible. Condylar neck fractures and displaced fractured segments are associated with an increased risk of development of facial nerve palsy.