Efficacy of the Retroparotid Trans-Masseteric Approach via Retromandibular Incision in ORIF of Subcondylar Fractures: Our Institution Experience

Abstract

Background: Fractures of the mandible subcondyle have always presented a challenge to the maxillofacial surgeon, with a myriad of treatment options existing ranging from conservative management to open reduction and internal fixation (ORIF) to condylotomy. The complex anatomy of the region poses a challenge, with injury to the facial nerve branches being the primary concern. Objective: This study evaluated the efficacy of a modified retromandibular approach, with retroparotid trans-masseteric dissection for ORIF of subcondylar fractures. Methodology: Twenty-five patients with subcondylar fractures at varying levels were treated surgically by ORIF using this approach. Results: All patients managed by this modified retromandibular approach had satisfactory results with restoration of vertical ramal height, satisfactory mouth opening, stable occlusion and no facial nerve damage post-op. Conclusion: In our study, the modified retromandibular approach, with retroparotid trans-masseteric approach was effective in surgical management of subcondylar fractures by ORIF with minimal complications.