Postoperative complications associated with the retromandibular approach: a retrospective analysis of 118 subcondylar fractures.
OBJECTIVE
The purpose of this study was to evaluate the rate of complications associated with the retromandibular approach.


METHODS
The design of this research was a retrospective case-series study. Included were patients who 1) underwent open reduction and internal fixation of the condylar or subcondylar area through a retromandibular approach and 2) had a complete and available medical chart. Excluded were 1) patients treated endoscopically or by other approaches and 2) patients with preoperative facial paralysis. The data collected were age, gender, medical comorbidities, tobacco use, mechanism of injury, anatomic location, concomitant facial fractures, follow-up time, antibiotic protocol, and complications.


RESULTS
One hundred eight patients (81 male; 118 condyles; age, 13 to 82 yr; mean, 35.6 ± 15.8 yr) met the inclusion criteria. Six patients never returned for postoperative visits and the mean follow-up time for all other patients was 6.5 months (8 days to 5.5 years). Twenty-six cases (22%) of temporary paralysis and 1 case of permanent facial paralysis were noted. Eight patients (6.8%) had persistent partial facial paralysis at their last visit, but all had short postoperative follow-ups. Fourteen cases (11.9%) of infection, 4 salivary fistulas, 2 sialoceles, 1 case of Frey syndrome, and 2 seromas were observed.


CONCLUSIONS
The retromandibular approach is a safe method for the treatment of condylar process fractures and major complications are rare.
Assistant Professor, Department of Oral and Maxillofacial Surgery, Centre Hospitalier Universitaire de Québec, Université Laval, Hôpital de l'Enfant-Jésus, Québec, Québec, Canada. Electronic address: carl.bouchard@fmd.ulaval.ca.
Carl
C
Bouchard
Dental Student, Centre Hospitalier Universitaire de Québec, Université Laval, Hôpital de l'Enfant-Jésus, Québec, Québec, Canada.
Marie-Hélène
MH
Perreault
D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000150:complications* / Q000601:surgery*; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012907:Smoking; D018709:Statistics, Nonparametric; D014481:United States; D055815:Young Adult
D000900:Anti-Bacterial Agents