J Korean Assoc Oral Maxillofac Surg.  2018 Apr;44(2):73-78. 10.5125/jkaoms.2018.44.2.73.

Complications of the retromandibular transparotid approach for low condylar neck and subcondylar fractures: a retrospective study

• Van Hevele J
• Nout E

• KMID: 2410583
• DOI: http://doi.org/10.5125/jkaoms.2018.44.2.73

Abstract

OBJECTIVES
The goal of this study was to evaluate the rates of complications, morbidity, and safety with the transparotid approach.
MATERIALS AND METHODS
A retrospective study was conducted and consisted of 53 surgically treated patients in the past five years for low condylar neck and subcondylar fractures. Only patients with malocclusion and who underwent open reduction with internal fixation with the retromandibular transparotid approach were included. The examined parameters were postoperative suboptimal occlusion, deflection, saliva fistula, and facial nerve weakness.
RESULTS
Fifty-three patients had an open reduction with internal fixation on 55 sides (41 males, 77.4%; mean age, 42 years [range, 18-72 years]). Four patients (7.5%) experienced transient facial nerve weakness of the marginal mandibular branch, but none was permanent. Four patients had a salivary fistula, and 5 patients showed postoperative malocclusion, where one needed repeat surgery after one year. One patient showed long-term deflection. No other complications were observed.
CONCLUSION
The retromandibular transparotid approach is a safe procedure for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.

Keyword

Maxillofacial surgery; Mandibular fractures; Open fracture reduction; Parotid gland

MeSH Terms

Facial Nerve
Fistula
Humans
Male
Malocclusion
Mandibular Fractures
Neck*
Parotid Gland
Reoperation
Retrospective Studies*
Saliva
Surgery, Oral

Figure

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  Fig. 1 Vertical incision line of 2 cm, parallel to the posterior border of the mandible.

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  Fig. 2 Exposure of the fracture site by placing the reversed retractor behind the posterior border of the mandible.

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  Fig. 3 Preoperative computed tomography image of bilateral subcondylar fracture in patient who needed new intervention one year after fracture management.

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  Fig. 4 Postoperative cone-beam computed tomography image of the restored right subcondylar fracture by one 2.0 mm miniplate in the same patient who needed new surgery one year after initial surgery.

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