Application of Modified Retromandibular Approach Indirectly From the Anterior Edge of the Parotid Gland in the Surgical Treatment of Condylar Fracture
Purpose
To introduce a new surgical approach for open reduction and internal fixation of condylar fracture.
Patients and Methods
In this study, 36 patients with condylar fractures (51 sides) and those of the mandibular ramus and coronoid process were treated using a modified retromandibular approach indirectly from the anterior edge of the parotid gland. The degree and type of mouth opening, occlusal relationship, facial nerve function, and other complications in the patients were assessed and evaluated.
Results
During the follow-up conducted over 12 to 24 months, x-ray examinations revealed good fracture healing. The occlusal relationship and degree and type of mouth opening improved significantly over those before operation. During the final follow-up at 24 months, no case of ankylosis and/or salivary fistula was observed. Major complications at 1 week postoperation included temporary injury to the facial nerve branches in 4 cases; this condition improved after 1 to 3 months.
Conclusions
Open reduction and internal fixation of condylar fracture by using the modified retromandibular approach indirectly from the anterior edge of the parotid gland has many advantages. Compared with the traditional surgical incision, this method is simple and short, and the completely exposed operative field facilitates reduction and fixation. Compared with transparotid approaches, it substantially reduces the risk to the facial nerve. At the same time, this method is not only suitable for the surgical treatment of condylar fractures but also for those of the mandibular ramus and coronoid process.
⁎Associate Professor, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, P.R. China
†Assistant Professor, Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, P.R. China
‡Associate Professor, Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, P.R. China
§Assistant Professor, Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, P.R. China
¶Associate Professor, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, P.R. China
‖Associate Professor, Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, P.R. China
#Professor and Director, Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, P.R. China
Address correspondence and reprint requests to Dr Tian: Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, No.14, 3rd Section, Renmin South Road, Chengdu, P.R. China 610041
Wei Tang and Chao Gao contributed equally to this study.
This work was supported by generous grants from the Chinese National Natural Science Foundation (no. 30772423) and the Programs of Science and Technology Commission Foundation of Sichuan Province, China (nos. 2006Z09-022 and 0040305301091).
ABSTRACT