A comparative evaluation of the outcome of treating condylar fractures with the mini retromandibular and the preauricular approaches

Abstract

AimTo compare the outcome of treating condylar fractures with the mini retromandibular and the preauricular approaches. Materials and methodsThe study group included 31 patients with 36 fractured condyles treated by the preauricular, and the mini retromandibular approaches among which 26 were unilateral condylar fractures and 5 were bilateral condylar fractures over a time period of 5 years. Treatment outcomes were evaluated for a minimum of 1 year follow up considering the following parameters: maximum mouth opening, lateral movement on fractured and opposite side, protrusion, mandibular movements, occlusion, scar formation, facial nerve weakness and salivary fistula, time taken for procedure. ResultsIn all cases, occlusion was restored with good anatomical fracture reduction. The mean operating time was longer in the preauricular group than in the mini retromandibular group. The resultant scar was satisfactory in almost all patients with the mini retromandibular approach. Pain was lesser in the mini retromandibular approach. Facial nerve weakness was found in 1 patient out 19 in case of the mini retromandibular approach in which the whole nerve was lost and 3 patients out of 12 in case of the preauricular approach in which only the temporal branches of the facial nerve were lost. Complete recovery of the facial nerve function without any residual weakness was observed in all the affected patients after 3 months in both the groups. ConclusionThe mini-retromandibular approach is the best choice as compared to the preauricular approach because it is extremely easy and fast to perform, presents a very low risk to the facial nerve and leaves a barely noticeable scar in a relatively hidden region.