Modified Blair’s (Transparotid) Approach for Open Reduction of Condylar Fractures - Our Experience

Abstract

The treatment of condylar fractures is complex and controversial.The aim of the present study is to evaluate the treatment outcomes of open reduction of condylar fractures using Modified Blair’s (Transparotid) approach. Materials and Methods: A prospective study was conducted March 2021 to April 2023. Patients reporting to the department with condylar neck/ subcondylar fractures with or without other facial bone fractures and requiring open reduction internal fixation were included in the study. Modified Blair’s (Transparotid) approach was used to expose the condylar fracture site. Intraoperative surgical time of exposure, post-operative variables like swelling, pain, status of occlusion, facial nerve dysfunction, salivary leakage (salivary fistula/sialocele), Frey’s syndrome, greater auricular nerve damage, subjective assessment of scar esthetics were recorded after immediate post-op day 1, after 1st post-op week, after 1st post-op month, after 3rd post-op month and after 6th post-operative month. Results: The study included 36 condylar fractures sites in 30 patients, 24 unilateral and 6 bilateral. The mean average time from incision to exposure of fracture site was 22.5 minutes. Mild occlusal discrepancy was recorded in 3 patients which was corrected with elastic traction in the post-operative period. Transient facial nerve dysfunction was recorded in 6 patients with spontaneous recovery of nerve function within 6 months. No other major complications were noted. Conclusion: The Modified Blairs (transparotid) approach provided sufficient exposure of the condylar fracture site to facilitate anatomical reduction. It is a good technique and provides stable results with low complication rates and acceptable scar.