Application of modified retromandibular approach indirectly from the anterior edge of the parotid gland in the surgical treatment of condylar fracture.
OBJECTIVE
To introduce a new surgical approach for open reduction and internal fixation of condylar fracture.


METHODS
In this study, 36 patients with condylar fractures (51 sides) and those of the mandibular ramus and coronoid process were treated using a modified retromandibular approach indirectly from the anterior edge of the parotid gland. The degree and type of mouth opening, occlusal relationship, facial nerve function, and other complications in the patients were assessed and evaluated.


RESULTS
During the follow-up conducted over 12 to 24 months, x-ray examinations revealed good fracture healing. The occlusal relationship and degree and type of mouth opening improved significantly over those before operation. During the final follow-up at 24 months, no case of ankylosis and/or salivary fistula was observed. Major complications at 1 week postoperation included temporary injury to the facial nerve branches in 4 cases; this condition improved after 1 to 3 months.


CONCLUSIONS
Open reduction and internal fixation of condylar fracture by using the modified retromandibular approach indirectly from the anterior edge of the parotid gland has many advantages. Compared with the traditional surgical incision, this method is simple and short, and the completely exposed operative field facilitates reduction and fixation. Compared with transparotid approaches, it substantially reduces the risk to the facial nerve. At the same time, this method is not only suitable for the surgical treatment of condylar fractures but also for those of the mandibular ramus and coronoid process.
Tang
Wei
W
State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China. mydrtangwei@yahoo.com.cn
Gao
Chao
C
Long
Jie
J
Lin
Yunfeng
Y
Wang
Hang
H
Liu
Lei
L
Tian
Weidong
W
D000328:Adult; D001860:Bone Plates; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D019248:Jaw Fixation Techniques / Q000295:instrumentation; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries*; D008337:Mandibular Fractures / Q000601:surgery*; D008406:Masseter Muscle / Q000601:surgery; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D010306:Parotid Gland; D055815:Young Adult