Submandibular, preauricular and the transparotid surgical approaches to fractures of the mandibular condyle: a comparative study
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 11, Pages 5450-5454
AbstractAim: The purpose of this study was to compared the submandibular, preauricular and the transparotid approaches to the condyle with respect to these parameters and correlated them with the specific features of condylar fractures.
Material and methods: A Retrospective study was conducted in the Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India from May 2019 to October 2019. 120 Patients with condylar fracture that required open reduction and internal fixation were include in this study. All patients were classified based on Spiessl and Schroll classification of condylar fractures, using radiological examination, into three groups- preauricular group (type VI), submandibular group (type II and type IV), and the transparotid group (type IIIb, type IIIc, and type V). Parameters like post-op IMF, palsy of facial nerve, scar, wound infection, malocclusion and plate retrieval were noted.
Results: 120 condylar fractures were included in this study. 26(21.67%) of them were women whereas 94(78.33%) were men with a p value of 0.41 The mean age in the preauricular group was 37.06 years, 34.52 years in the submandibular group and 36.07 years in the transparotid group with a standard deviation of 10.96, 9.97, and 8.67 respectively. RTA was the major aetiology of injury (78.33%) in all the three groups followed by self-fall and assault. 92.5% of fractures in the pre-auricular group, 82.5% of fractures in the sub-mandibular group and 55% of the fractures in the trans-parotid group were associated with other fractures of the facial skeleton. Post-op IMF was present in 15% of preauricular group when compared 0% in the other two groups facial nerve palsy was seen in 7.5% of preauricular cases, 25% of submandibular group and 17.5% of trans-parotid group. unfavorable scar formation was recorded in 12.5% of pre-auricular group, 37.5% of submandibular group and 40% trans-parotid group. Wound infection was seen in 12.5% of preauricular group, 22.5% of submandibular group and 7.5% of transparotid group.
Conclusion: The inferior neck fractures seem to benefit from ORIF via submandibular approach, high neck fractures via the transparotid fractures and the condylar head fractures via the pre auricular approach with a low rate of complications.
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