Transparotid Approach in the Treatment of Intracapsular Condylar Fracture

Abstract

Open reduction and internal fixation of intracapsular condylar fractures is a great challenge due to the confined access. This study aims to explore the feasibility of transparotid approach in the treatment of intracapsular condylar fractures. Eight patients with intracapsular condylar fractures were enrolled in this study. A minimized preauricular incision and transparotid access was used. Blunt dissection was performed perpendicularly to the condyle. The reduction and fixation of intracapsular condylar fractures were performed. After confirming that the fracture was fixed rigidly, the articular disc was repositioned. Using this incision, the condylar head and fracture stump were exposed perpendicularly. No extensive incision was needed and minimal invasion was realized. Postoperative CT scan showed that the condyle had been repositioned and fixed in the normal position. Occlusal disturbance, restriction of mouth opening, and lateral deviation were not found in the follow-up. Transparotid approach gave an optimal view of the bony field, which allowed surgeons to work perpendicularly to the fracture, and facilitated the reduction of medially displaced proximal stumps. It was regarded as an ideal and valuable alternative in this potentially complicated procedure.