Modified tragus edge approach for mid-level or low condylar fractures

Area of Science:

• Oral and Maxillofacial Surgery
• Otolaryngology
• Plastic Surgery

Background:

• Condylar fractures are common facial injuries requiring surgical intervention.
• Traditional surgical approaches may carry risks of complications such as facial nerve damage and parotid fistula.
• A need exists for safer and more effective surgical access methods.

Purpose of the Study:

• To evaluate the safety and efficacy of a modified tragus edge approach (MTEA) for surgical access to mid-level or low condylar fractures.
• To compare the outcomes of MTEA with the conventional retromandibular approach.

Main Methods:

• The modified tragus edge approach (MTEA) was utilized in 45 patients (59 sides) for treating mid-level or low condylar fractures.
• Patient outcomes including scarring, parotid fistula, facial nerve function, occlusion, deviation, and mouth opening were assessed.
• A comparative analysis was performed with 41 patients (64 sides) treated via the retromandibular approach.

Main Results:

• The MTEA group exhibited minimal scarring and no instances of parotid fistula.
• Temporary facial nerve damage occurred in 3.4% of MTEA cases, and mouth opening limitation in 6.7%.
• Compared to the retromandibular approach, MTEA demonstrated significantly lower risks of facial nerve dysfunction and parotid fistula, with similar rates of malocclusion and mouth opening limitation.

Conclusions:

• The modified tragus edge approach (MTEA) is a safe surgical technique for mid-level and low condylar fractures.
• MTEA provides favorable aesthetic results and reduces the incidence of specific surgical complications.
• MTEA is a suitable alternative surgical access for condylar fracture treatment.