Retromandibular transparotid approach to mandibular subcondylar and high ramus fractures: two-point fixation.

Background: Although the fractures of the mandibular condylar region are very common, the controversies about the treatment of this area is still ongoing. In recent years, general agreement has emerged that open treatment is more effective than closed approaches for extracapsular condylar fractures. However, this time, the method of surgical approach has become controversial. The aim of this study was to evaluate the effectiveness of the retromandibular transparotid approach for the fixation of subcondylar/high ramus mandible fractures.

Methods: Subcondylar/high ramus mandible fractures were operated via the retromandibular transparotid approach with a two-point fixation in 24 patients. The patients were evaluated for bleeding during the operation and for hematoma, infection, Frey's syndrome, salivary fistula, facial nerve damage, occlusion, fracture site stability, chronic pain in the fracture site, hypoesthesia of the ear, and temporomandibular (TME) joint movements in the postoperative period.

Results: Only one major complication was encountered in one (4.1%) patient, which was damage to the temporal branch of the facial nerve.

Conclusion: The retromandibular transparotid approach appears to be a safe and effective method for the internal fixation of extracapsular condylar fractures.