Comparative study between preauricular retromandibular anteroparotid approach and retromandibular transparotid approach in open reduction and internal fixation of subcondylar fracture on facial nerve injury and parotid fistula

Abstract

Background: Condyle fractures account for 17.5 percent to 50 percent of all mandibular fractures, although there are still many debates on whether to treat them close or open. There are several techniques of managing the mandibular condyle, each with its own set of benefits and drawbacks. Aim: compare the innovative preauricular transmasseteric anteroparotid approach (P-TMAP) to the usual retromandibular transparotid technique. Patients and methods: 20 cases, patients with an odd number (1,3,5,7,9,11,13,15,17,19) received a preauricular transmasseteric anteroparotid approach (study group), while patients with a double number (2,4,6,8,10,12,14,16,18,20) had a retromandibular transparotid approach (control group) (control group). Patients were closely monitored for six months. Results: Fractures were caused by a road traffic accident (RTA) in 6(60%) of the cases, interpersonal violence in 3(30%) of the cases and falling in 1(10%) of the cases in both groups. Immediate postoperative facial nerve affection was higher in the transparotid approach group (30%) than in the anteroparotid approach group (10%), but both groups exhibited no statistically significant difference three months after surgery. There were no parotid injuries in any of the cases in either group.