Retromandibular Approach for Subcondylar Fractures: A Prospective Study


Affiliations

  • Shyam Shah Medical College, Department of Dentistry, Rewa, Madhya Pradesh, India
  • Nil Ratan Sircar Medical College and Hospital, Department of Neurosurgery, Kolkata, West Bengal, India
  • Sri Aurbindo College of Dentistry, Department of Oral Pathology, Indore, Madhya Pradesh, India
  • Shyam Shah Medical College, Department of General Surgery, Rewa, Madhya Pradesh, India

Abstract

Background: Condylar fractures accounts for 25-50% of all mandibular fractures. It can be extracapsular or intracapsular, nondisplaced, displaced, deviated, or dislocated from the disc.

Objective: To evaluate the retromandibular transparotid approach for open reduction & internal fixation of subcondylar fractures for post-operative occlusal status, stability of fixation & postoperative complications.

Material and Methods: The prospective study was performed on 24 patients (18 male and 8 females) sustaining 26 subcondylar fractures who were treated surgically utilizing retromandibular transparotid incision.

Results: The most common etiology of injury was road traffic accidents in 62.5% patients. Satisfactory anatomic reduction and occlusion was achieved in all patients. The incidence of transient facial nerve injury was 16.67%. The facial nerve returned to normal function in 3 months in all the 4 affected patients.

Conclusion: The incision provides easy visualization of the subcondylar region from the posterior edge of the ramus to the sigmoid notch, allows the perpendicular placement of screws to the fracture site, with minimal post operative complications and satisfactory esthetic results.


Keywords

Subcondylar Fractures, Surgical Approach, Retromandibular Transparotid Approach.

Subject Discipline

Dentistry

Full Text:

References

Ellis E 3rd, Moos KF, el-Attar A. Ten years of mandibular fractures: an analysis of 2,137 cases. Oral Surg Oral Med Oral Pathol 1985;59(2):120-9.

D Agostino A, Trevisiol L, Procacci P, Favero V, Odorizzi S, Nocini PF. Is the Retromandibular Transparotid Approach a Reliable Option forthe Surgical Treatment of Condylar Fractures? J Oral Maxillofac Surg 2017;75(2):348-56.

Rashid A, Eyeson J, Haider D, van Gijn D, Fan K. Incidence and patterns of mandibular fractures during a 5-year period in a London teaching hospital. Br J Oral Maxillofac Surg 2013 Dec;51(8):794-8.

Yang L, Patil PM. The retromandibular transparotid approach to mandibular subcondylar fractures. Int J Oral Maxillofac Surg 2012;41:494–9.

Kang DH. Surgical Management of a Mandible Subcondylar Fracture. Archives of Plastic Surgery 2012;39(4):284-90.

Zide MF, Kent JN. Indications for open reduction of mandibular condyle fractures. J Oral Maxillofac Surg 1983; 41:89.

Ebenezer V, Ramalingam B. Comparison of Approaches for the Rigid Fixation of SubCondylar Fractures. Journal of Maxillofacial & Oral Surgery 2011;10(1):38-44.

Mohan AP, Jeevan Kumar KA, Venkatesh V. Comparison of Preauricular Approach Versus Retromandibular Approach in Management of Condylar Fractures J Maxillofac Oral Surg 2012;11(4):435-441.

Hinds E, Girotti W: Vertical subcondylar osteotomy: a reappraisal. J Oral Surg 24:164e170, 1967.

Shi D, Patil PM, Gupta R. Facial nerve injuries associated with the retromandibular transparotid approach for reduction and fixation of mandibular condyle fractures. J Craniomaxillofac Surg 2015 Apr;43(3):402-7.

Narayanan V, Kannan R, Sreekumar K. Retromandibular approach for reduction and fixation of mandibular condylar fractures: A clinical experience. Int J Oral Maxillofac Surg 2009;38:835‑9.

Bhutia O, Kumar L, Jose A, Roychoudhury A, Trikha A: Evaluation of facial nerve following open reduction and internal fixation of subcondylar fracture through retromandibular transparotid approach. Br J Oral Maxillofac Surg 2014 Mar;52(3):236-40.

Ellis E, McFadden D, Simon P, Throckmorton G. Surgical complications with open treatment of mandibular condylar process fractures. J Oral Maxillofac Surg 2000; 58:9508.


Refbacks

  • There are currently no refbacks.