Retromandibular transparotid approach compared with transmasseteric anterior parotid approach for the management of fractures of the mandibular condylar process: a prospective randomised study

Parihar, Vinay Singh; Bandyopadhyay, Tapas Kumar; Chattopadhyay, P. K.; Jacob, Shiju Mathew

doi:10.1016/j.bjoms.2019.07.010

Cited by 12 publications

(13 citation statements)

References 21 publications

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“…retroparotid deep subparotid retromandibular approach), in contrast to the more recent approaches such as the antero-and transsparotid approaches, and the angular/periangular/high submandibular approach. The latter represents an approach with the lowest complication rate compared to all others cited (3,4,10,12,13,14,15,16,17,18).…”

Section: Discussionmentioning

confidence: 92%

“…Basically, these surgical approaches differ because of their relationship to the parotid gland (retro-viz. subparotid, transparotid, anteroparotid and infraparotid) and the masseter muscle, using either a transmasseteric incision (antero-and transparotid) or partial dissection (retroparotid), or a full or subtotal transsection of the masseteric muscle, the latter utilizing an angular/high submandibular approach which gained popularity during the last decade because of lower occurrences of both TFNI and PFNI (3,4,8,10,12,13,14,15,16,17,18).…”

Section: Introductionmentioning

confidence: 99%

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Periangular transmasseteric infraparotid approach in the treatment of condylar-base and low condylar‑neck fractures

Hirjak¹,

Vavro²,

Dvoranová³

et al. 2021

BLL

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AIM: Mandibular condylar fractures account for 25 to 52 % of all mandibular fractures. Though current literature favors open reduction and internal fi xation (ORIF) of condylar-base and low condylar-neck fractures, extraoral approaches are usually considered to be complicated by the risk of facial nerve injury and other possible complications. This study was undertaken to demonstrate that the periangular transmasseteric infraparotid surgical approach (TMIP) to condylar-base and low condylar-neck fractures provides excellent access to the bony fragments with minimal risk of complications such as facial nerve and parotid gland injury. PATIENTS: In the period from January 2010 to December 2018, 81patients (96 fractures) with condylar-base and low condylar-neck fractures underwent ORIF via periangular transmasseteric infraparotid surgical approach. RESULTS: The results of this retrospective study showed minimal postoperative complications. The periangular transmasseteric infraparotid surgical approach allowed precise anatomic repositioning and fi xation of the bony fragments in almost all cases except for two juvenile cases with noticeable scars and one case with plate fracture. There were no transient or permanent facial nerve palsies, parotid gland or salivary fi stulae complications during a 12-month follow-up period. CONCLUSION: The periangular infraparotid transmasseteric approach to ORIF of condylar-base and low condylar-neck fractures is an effective and safe approach allowing accurate anatomic reposition and fi xation of the fragments with minimum surgical complications (Tab. 1, Fig. 12, Ref. 21). Text in PDF www.elis.sk KEYWORDS: condylar base, condylar neck, open reduction and internal fi xation (ORIF), facial nerve injury (FNI), transient/permanent facial nerve palsy, parotid gland injury.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Periangular transmasseteric infraparotid approach in the treatment of condylar-base and low condylar‑neck fractures

Hirjak¹,

Vavro²,

Dvoranová³

et al. 2021

BLL

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“…Patients were placed into 2 groups of 13 members each; one group was managed using ORIF by means of a retromandibular transparotid approach which has recently been well described by Parihar et al 3 , while the other group was treated with ORIF by means of the retromandibular retroparotid approach described by Ebenezer et al in 2014 8 .…”

Section: Methodsmentioning

confidence: 99%

“…The management of condylar trauma has remained a point of contention amongst experts, regardless of the advances in surgical modalities and methodologies, and the treatment plan is often determined by the surgeon's preference and experience 3 . Owing to the composite anatomical site, surgical approaches in this area should provide good visualization and allow the surgeon to precisely reduce the fracture and provide stable internal fixation 4 .…”

Section: Introductionmentioning

confidence: 99%

The retromandibular transparotid approach vs. retromandibular retroparotid approach for the mandibular condyle

et al. 2021

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Aim: The mandible is regarded as a frequently fractured bone in patients who present with maxillofacial trauma accounting for almost 15.5% to 59% of all facial fractures. Managing condylar trauma has remained to be a point of contention amongst experts, regardless of the advances in surgical modalities and methodologies, and the treatment plan is often determined by the preference and the experience of the surgeon. There exist various approaches in the literature, each with its own specific benefits and drawbacks. With this study, we aimed to evaluate the prevalence of post-operative complications in patients who experienced ORIF by means of the retromandibular approach, by comparing the outcomes of one group having undergone transparotid surgery, with another that underwent retroparotid surgery. Methods: An experimental trial was undertaken. Convenience sampling was done from among the cases of condylar neck and base fracture visiting the department of OMFS, Dow University of Health Sciences from January 2017 to December 2019. An overall 26 patients were divided into 2 groups of 13 members each; one was managed using Open Reduction Internal Fixation (ORIF) by means of a retromandibular transparotid approach while the other group was treated with ORIF by means of a retromandibular retroparotid approach. A 6 month follow-up was done to assess range of active motion, occlusion, and complications such as deviation/deflection, neural injury, infections, sialocele, salivary fistulae and Frey’s syndrome in both groups. Results: There was no statistically significant difference between the two groups in terms of inter-incisal opening, right and left lateral movements, or protrusion. One patient in the retroparotid group had deviation on mouth opening (7.69%), while one in the transparotid group reported with infection (7.69%), and 2 developed post operative seromas (15.38%). None had persisting facial nerve palsy at 6 months. Conclusion: We find no significant disparity between the 2 approaches at a follow-up of 6 months; therefore, the primary determining factor for selection of either technique is surgeon preference and appropriate case selection.

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“…The approach to the mandibular condyle region is complex due to the existence of the branches of the facial nerve which is why the management of condylar fractures comes into discussion as to when to perform an open or closed treatment. Although the absolute and relative indications are well known, the best treatment for each patient continues to be the surgeon's choice [1,2].…”

Section: Introductionmentioning

confidence: 99%

Retromandibular Approach as a Method for Open Reduction and Internal Fixation of Mandibular Condyle Fractures. Experience in the Regional Hospital 1º de Octubre, ISSSTE and Literature Review

Mgr¹,

Amn²,

Casj³

et al. 2021

Int J Dent Oral Health

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Mandibular condyle fractures constitute 17.5% to 52% of mandibular fractures. Open reduction with internal fixation and closed reduction are described for their treatment. Fonseca describes the absolute indications for open treatment when there is displacement of the mandibular condyle to the middle cranial fossa, foreign body invasion, extra capsular displacement of the condyle, and/or malocclusion not susceptible to closed reduction. It includes indications with vast evidence for open treatment of bicondyle fractures, condylar displacement greater than 45 degrees, reduction in the height of the mandibular ramus greater than or equal to 2mm, fractures associated with fractures of the middle third and when there is unstable occlusion. The above establishes sufficient evidence to perform open treatment in various situations of condylar fractures. Regarding the approach of the mandibular condyle region there are different surgical techniques, such as, the preauricular, retroauricular, submandibular, retromandibular, and rhytidectomy approaches.

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Retromandibular transparotid approach compared with transmasseteric anterior parotid approach for the management of fractures of the mandibular condylar process: a prospective randomised study

Cited by 12 publications

References 21 publications

Periangular transmasseteric infraparotid approach in the treatment of condylar-base and low condylar‑neck fractures

Periangular transmasseteric infraparotid approach in the treatment of condylar-base and low condylar‑neck fractures

The retromandibular transparotid approach vs. retromandibular retroparotid approach for the mandibular condyle

Retromandibular Approach as a Method for Open Reduction and Internal Fixation of Mandibular Condyle Fractures. Experience in the Regional Hospital 1º de Octubre, ISSSTE and Literature Review

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