title: Transoral vs. extraoral approach in the treatment of condylar neck fractures.
abstract: OBJECTIVE
  The aim of this study was to assess a non-endoscopic transoral versus extraoral technique in the open reduction and internal fixation of displaced or dislocated fractures of the condylar neck.
  
  
  METHODS
  A total of 104 patients, treated from 2007 to 2012 with 114 class II or class IV fractures according to Spiessl and Schroll were included in this study. Facial nerve function, scarring, pain and functional clinical parameters, such as protrusion, mediotrusion and maximum interincisal distance, were judged clinically (at 21 ± 12.1 months); repositioning and reossification were measured upon preoperative, postoperative and follow-up (at 8.8 ± 7 months) radiographs. Patient satisfaction was evaluated using the OHIP-G 14 questionnaire.
  
  
  RESULTS
  In all, 36 patients (35%) with 43 fractures (38%) presented for clinical follow-up. Both treatment groups showed clinically and radiologically comparable results. Scarring was obvious in all extraorally treated patients, and hypertrophic scars occurred in four class IV cases (24%). One class IV patient (6%) had a persistent facial nerve palsy; temporary pareses were more frequent (n = 4; 24%).
  
  
  CONCLUSIONS
  The transoral approach did not jeopardize facial nerve function, and extraoral scars were avoided. Repositioning and fixation results and the frequency of revision operations were comparable. The transoral approach can be recommended generally in class II and class IV cases.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany. Electronic address: andboehle@gmail.com.
authors.forename: Andreas Paul
authors.initials: AP
authors.lastname: Boehle
authors.affiliation: Department of Oral and Maxillofacial Surgery, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Herrmann
authors.affiliation: Department of Oral and Maxillofacial Surgery, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany.
authors.forename: Sharam
authors.initials: S
authors.lastname: Ghanaati
authors.affiliation: Department of Oral and Maxillofacial Surgery, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Ballon
authors.affiliation: Department of Oral and Maxillofacial Surgery, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany.
authors.forename: Constantin Alexander
authors.initials: CA
authors.lastname: Landes
mesh_terms: D000328:Adult; D002921:Cicatrix / Q000209:etiology; D017439:Cicatrix, Hypertrophic / Q000209:etiology; D005155:Facial Nerve Diseases / Q000209:etiology; D005157:Facial Pain / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D000072039:Fracture Dislocation / Q000000981:diagnostic imaging / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008337:Mandibular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009055:Mouth / Q000601:surgery; D000070799:Open Fracture Reduction / Q000379:methods*; D010243:Paralysis / Q000209:etiology; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011862:Radiography, Panoramic / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Condylar neck fractures; Mandibular fractures; Transoral approach