Transmasseteric antero-parotid approach through modified preauricular lazy ‘S’ incision for management of mandible condylar fractures: a prospective study

Kusuma Duda,Ramsetti S,Rajasekhar Gaddipati ,Bharathi Suvvada

doi:10.18314/jdms.v1i1.1436

Abstract

To report the surgical details and results of our technique of Transmasseteric antero-parotid approach (TMAP) through modified preauricular lazy ‘S’ incision for management of mandibular condylar fractures. This was an observational analysis of 65 patients where 25 patients were treated with conventional preauricular approach, 25 patients with closed reduction and 15 patients with a mean age of 29.4 years with condylar fractures were treated by TMAP technique between September 2016 to June 2018. Aim of the study was to evaluate the proficiency of TMAP approach for open reduction and internal fixation (ORIF) of condylar fracture. The only complication which was noticed was sialocele formation and managed by drainage. TMAP is versatile since it avoids facial nerve damage as it involves identification and preservation of facial nerve and has less chances of post-operative complications related to facial nerve injury. The accessibility achieved by this approach is fair enough to facilitate anatomic reduction and fixation of condyle.

Highlights

Mandibular condyle fractures are most common fractures which attribute up to 25%-50% of the maxillofacial fractures [1,2]
This was an observational analysis of 65 patients with condylar fractures where 25 were managed with closed reduction, 25 with conventional preauricular approach and 15 patients with condylar fractures treated by Transmasseteric antero-parotid approach (TMAP) approach between September 2016 to May 2018
Among the 65 cases 25 cases where managed by closed reduction as the occlusion was achieved by intermaxillary fixation, 25 cases treated through conventional technique and 15 cases managed by this technique only 4 patients were presented with bilateral condylar fractures

Summary

Introduction

Mandibular condyle fractures are most common fractures which attribute up to 25%-50% of the maxillofacial fractures [1,2]. Some practitioners prefer closed reduction due to the complex anatomy. Surgical management is inevitable in few cases to establish accurate anatomical reduction of condyle with occlusal stability and to prevent the temporomandibular joint (TMJ) morbidity. There are certain indications and contra indications for management of condylar fractures which eased the decision making in surgical intervention of condylar fractures [3,4,5,6]. Surgical management of condylar fractures involves dealing with complex anatomy of facial nerve and is associated with facial nerve palsy or weakness which increases post operative morbidity and unaesthetic sequlae [7,8]. Six types of facial nerve branching patterns were described which are helpful during intervention [9]

Methods

Results

Conclusion