The post-auricular approach for gap arthroplasty - a clinical investigation

Objective of this prospective study was to evaluate and compare posterior auricular approach for surgery of temporomandibular joint ankylosis with preauricular approach. These evaluations were done on the basis of certain parameters like incidences of facial nerve injury, time taken to expose ankylotic mass, haemorrhage and quality of exposure of joint and surrounding structures. This study was conducted among 15 patients of temporomandibular joint ankylosis. A total number of 30 joints were operated. These joints were divided in two groups i.e. Group A - preauricular group, Group B - postauricular group. Fifteen joints were operated in each group. Age of patients was in range of 4-65 years. All the patients were operated under general anesthesia. Preoperative, intraoperative and postoperative evaluations were done according to parameters. Patients were recalled up to 3 months for observations. Results have shown that in postauricular group incidences of facial nerve injury was significantly less, more time was taken to expose the ankylotic mass, incidences of haemorrhage was more and exposure of structures anterior to joint was difficult. Whereas preauricular approach is less time consuming, incidence of facial nerve damage is higher, exposure of structures anterior to joint is good and intraoperative incidences of haemorrhage is less.