Evaluation of Retro Mandibular Approach to Open Reduction and Internal Fixation of Condylar Fractures: A Cross-sectional Study

Abstract

Purpose The present study was carried out to evaluate the usefulness of mini retromandibular approach on accessibility, scarring and stability in open reduction and internal fixation of sub condylar fractures. Materials and MethodsFifteen patients underwent open reduction and rigid fixation of middle and low subcondylar fractures, with mini-retro mandibular approach.Results No signs of infection were observed in any patient postoperatively. Surgical scar was imperceptible and esthetically acceptable in all the cases. Out of 15 patients, only one patient had discrepancy in occlusion and after 2 months satisfactory centric occlusion was achieved. Salivary fistula (parotid fistula) was observed in 3 cases within 1 week postoperatively, which was treated spontaneously with the use of hypertonic saline. Transient facial nerve weakness was observed in 2 patients, in one patient it resolved in 4 weeks postoperatively and in second patient 3 months postoperatively. Mouth opening increased in all the patients with time. Average mouth opening at 1 week interval was 19.6 mm, at 2 months interval 28.2 mm, and after 6 months 38.33 mm suggesting that mouth opening gradually increased with time. At the end of 2 months postoperatively none of the patients had any restriction in lateral movements. At 2 months postoperatively 4 patients had deviation but none of the patients had any deviation 6 months postoperatively. Conclusion It is evident from the results of our study that open reduction and internal fixation using mini-retromandibular approach is good treatment option in management of mandibular condylar fractures.

Condylar fractures: Review of 40 cases

“…The criteria for ideal surgical approach are to be less invasive, easy learning, versatile, good exposure, and low incidence of complications. [ 26 ]…”

Prevalence of Frey syndrome following extraoral surgical treatment for mandibular fractures: a systematic review and meta-analysis

“…Among these studies, one adopted a cohort design, 42 while the remaining were cross-sectional in nature. [28][29][30][31][32][33][34][35][36][37][38][39][40][41] Geographically, the studies were primarily executed across Asia (including India, Japan, Turkey, and Nepal), followed by Europe (including Italy, France, Austria, and Switzerland), and finally America (including the USA and Canada). The representation of male participants averaged at 79.9%, and the mean age of participants ranged from 27 to 41.5 years, with a median age of 29.2 years.…”

Innsbruck-style Retromandibular Anterior Trans-parotid Approach for Condylar Fractures: A Retrospective Review of 39 Fractures

“…34 There are reports of minimally invasive surgery for condylar fractures as a mini-retromandibular approach using a 20-to 25-mm incision. 24,[34][35][36][37][38] Colletti et al treated condylar fractures at every level (from high-neck to low-subcondylar fractures) using the mini-retromandibular approach. This broad application is possible because the view is limited by the deeper part of the access and not the skin incision.…”