title: Modified tragus edge approach for mid-level or low condylar fractures.
abstract: The aim of this study was to evaluate and report a modified tragus edge approach (MTEA) for surgical access to mid-level or low condylar fractures. The MTEA was used on 45 patients (59 sides). All of the patients were reviewed for scarring, parotid fistula, facial nerve function, occlusion, deviation, and limitation of mouth opening (MO). Forty-one patients (64 sides) with middle or low level condylar fractures who underwent surgery by retromandibular approach during the same period were selected for comparison. In the MTEA group, scars were not obvious and there was no parotid fistula. The occlusion of four cases (8.9%) was not ideal, but returned to normal after 2 weeks of intermaxillary traction. Temporary facial nerve damage was present on two sides (3.4%). MO was not deviated in any patient, but was limited in the first 2 weeks after operation in three cases (6.7%). The risks of facial nerve dysfunction and parotid fistula were much higher in the retromandibular approach group than in the MTEA group, while the risks of malocclusion and limitation of MO were similar. MTEA is safe and has good aesthetic outcomes. MTEA represents an appropriate surgical access to mid-level and low condylar fractures.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Stomatology Hospital, College of Medicine, Zhejiang University, 395 Yanan Road, Hangzhou 310003, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Department of Oral and Maxillofacial Surgery, Stomatology Hospital, College of Medicine, Zhejiang University, 395 Yanan Road, Hangzhou 310003, China. Electronic address: oralzwq@163.com.
authors.forename: W
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: C
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: J
authors.initials: J
authors.lastname: Liu
mesh_terms: D000328:Adult; D004955:Esthetics, Dental; D020220:Facial Nerve Injuries / Q000209:etiology; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries*; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: condylar fracture; internal fixation; surgical approach