Numerous approaches have been described to access the fractured condyle. Unrestricted wide optical window to the fracture site and the safety of the facial nerve dictate the type of approach required. Aims: To evaluate the pre auricular transmassetric anterior parotid approach in 20 unilateral condylar fractures. Results: All the twenty cases evaluated showed adequate mouth opening, no signs of facial nerve palsy and sialocele. The transmassetric anterior parotid approach is a safe approach which can be used in the surgical management of condylar fractures and is of special value in obtaining excellent exposure in the cases of medially displaced condylar neck fractures.

Mandibular condylar fractures account for a sizeable segment amongst facial fractures. Previously most of these fractures were managed conservatively with periods of Intermaxillary fixation(IMF). Shortcomings of such an approach such as prolonged pain, Tmj dysfunction and delayed return to function has shifted the discourse to open reduction and internal fixation of the fractured mandibular condyle.ORIF is the universally accepted and mainstay of intervention. Numerous extra oral approaches have been employed with various modifications. The retromandibular transparotid approach is a relatively simple and direct approach to the posterior mandible, enabling the surgeon to deal with sub condylar and condylar neck fractures with relative ease. This approach is a safe approach and does not result in permanent palsy of any of the branches of the facial nerve. Aims: To analyse facial nerve function after ORIF of mandibular sub condylar fractures through the retromandibular transparotid approach. Materials and Methods: 25 patients reporting with unilateral condylar fractures, sub condylar (16) and neck fracture (9) (Ellis classification)consenting for the study were taken up. All patients were followed up for 8 months. Post-operative nerve function was evaluated at 24 hours after surgery, 1,4,12 weeks and at the end of 8 months. Results: 4(16%) patients presented with weakness of the facial nerve. Buccal branch (3) and zygomatic branch (1). In all cases the weakness was temporary and no permanent deficit was noted.

Aim: This study was intended to evaluate the knowledge and clinical skill of anesthesia residents pertaining to various intubation techniques employed in craniofacial surgery. Materials and Methods: A cross-sectional survey research design was employed in this study. A self-administered questionnaire survey was used to validate the knowledge and clinical skill of anesthesia residents pertaining to various intubation techniques employed in craniofacial surgery. In this regard, a preliminary study with a convenience sample of 156 anesthesia residents studying in various medical institutions across South India was conducted so as to assess the knowledge and clinical skill of anesthesia residents pertaining to various intubation techniques employed in craniofacial surgery. This study, while limited in sample size, benefits the craniofacial surgeons and anesthetists as target readers to assess the knowledge and clinical skill of anesthesia residents pertaining to various intubation techniques employed in craniofacial surgery Results: The results of this study reveal that majority of the anesthesia residents encountered craniofacial surgery during their residency period. However, only 19.87% have performed various intubation techniques that are employed in craniofacial surgery. Nearly 38.46% of the participants felt that blind awake intubation is the most difficult intubation technique to employ in the head-and-neck region and requires expertise. Nearly 78.84% of the participants felt that special training is required for handling craniofacial surgical cases under general anesthesia. Conclusion: The results of this study reveal that there is a dearth of knowledge and clinical exposure among anesthesia residents regarding various intubation techniques employed in craniofacial surgery. Educational and quality improvement initiatives in various intubation techniques could enhance anesthesia residents' knowledge and clinical exposure in managing various craniofacial surgical cases.

In the surgical correction of the cleft lip, the surgeon faces numerous challenges which make the task of obtaining appreciable esthetic results an arduous one. A multitude of problems can present to the surgeon after the surgical repair of cleft lip, such as hypertrophic scar, peaking and notching. In such a scenario Botulinum Toxin A can help achieve improved esthetic results. Botulinum toxin type A is a powerful neurotoxin which is produced by the anaerobic organism Clostridium Botulinum and when injected into a muscle causes interference with the neurotransmitter mechanism producing selective, transient paralysis of the muscle, which in turn reduces scar contracture. Aims: To evaluate the esthetic outcome of Botulinum Toxin A injection in cleft lip surgeries and to evaluate the role of Botulinum toxin A in unilateral cleft lip scars. Materials and Methods: 30 healthy unilateral cleft lip patients reporting for cleft procedure were taken up for the study. 6-8 units of Botulinum Toxin A was injected (after test dose) along pre-determined points. Both objective (Photographic evaluation) and subjective (Patient questionnaire method) evaluation was carried out after 1 year. Results: Photographic evaluation revealed that majority of the patients had either excellent or good esthetic outcomes. Scar characteristics were evaluated and most patients were happy or very happy with the surgical results.

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