The retromandibular transparotid approach for reduction and internal fixation of mandibular condylar fractures

Abstract

Introduction: The retromandibular transparotid approach is most useful for condylar and subcondylar fractures and provides the best access to the joint and ascending ramus. The study aims at evaluating the ease of access and outcomes encountered on using the retromandibular transparotid approach to access the fracture site for the open reduction and internal fixation (ORIF) of condylar and sub-condylar fractures. Materials and Methods: An observational clinical study was carried out among 10 patients with unilateral and bilateral condylar fracture requiring ORIF. Maximal interincisal mouth opening, facial swelling, occlusal discrepancy, facial nerve injury, scar formation, and acceptability and complications including wound dehiscence, infection, and sialocele/salivary fistula were assessed and measured preoperatively and postoperatively. Results: There was a notable improvement in mouth opening and facial nerve weakness. Postoperative intermaxillary fixation was done with selective patients who had a discrepancy in their occlusion. Preoperatively, swelling was present in four patients (40%) out of 10 patients studied. There was no incidence of sialocele/salivary fistula in any of the cases studied. Conclusion: Retromandibular transparotid incision is technique sensitive and thorough knowledge about the retromandibular area is must for good results and minimal morbidity. The cosmetic results are good in this approach, as well as the facial nerve injury were less in this without any permanent damages.

Manejo cirúrgico de fratura mandibular cominutiva por projétil de arma de fogo / Surgical management of comminuted mandibular fracture by firearm projectile

“…Um outro ponto importante, consiste no fato de que lesões penetrantes na glândula parótida podem gerar sialoceles, as quais são definidas como coleção salivar em tecido subcutâneo 17 . A paciente apresentou tal condição no pós-operatório, que são consideradas complicações comuns não só em indivíduos acometidos por PAF na região, mas também naqueles tratadas por meio de acessos extraorais em região submandibular e retromandiular, por exemplo 19,20,21 . Seu diagnóstico pode ser feito por uma série de exames complementares, mas nesse caso o exame físico foi soberano em detrimento dos sinais que se tornavam mais evidentes durante as refeições.…”

comparative study between preauricular retromandibular anteroparotid approach and retromandibular transparotid approach in open reduction and internal fixation of subcondylar fracture on facial nerve injury and parotid fistula

“…• 20 cases were selected from oral and maxillofacial surgery department faculty of dentistry Cairo university during perior between 2018-2021, then consecutively divided into two groups, group A include patients with odd number (1,3,5,7,9,11,13,15,17,19) had done preauricular transmasseteric anteroparotid approach while group B patients with events number (2,4,6,8,10,12,14,16,18,20) had done retromandibular transparotid approach.…”

“…Aim: compare the innovative preauricular transmasseteric anteroparotid approach (P-TMAP) to the usual retromandibular transparotid technique. Patients and methods: 20 cases, patients with an odd number (1,3,5,7,9,11,13,15,17,19) received a preauricular transmasseteric anteroparotid approach (study group), while patients with a double number (2,4,6,8,10,12,14,16,18,20) had a retromandibular transparotid approach (control group) (control group). Patients were closely monitored for six months.…”

Precise extratemporal pattern and intramuscular distribution of the facial nerve

“…The unexpected result was stated that the patients have the facial nerve injury such as hemiface (45.10%), upper division (23.53%), midfacial division (11.76), lower division (0.98), temporal branch (16.67), and marginal mandibular branch (11.55%). 51 Furthermore, marginal mandibular branch of the facial nerve was damage in 40% after the patients with condylar fractures received open reduction and internal fixation (ORIF) was reported by Singh (2020) 52…”