Modified Preauricular Transparotid Approach for Treating Mandibular Condylar Fractures

Area of Science:

• Maxillofacial Surgery
• Orthopedic Surgery
• Facial Trauma Reconstruction

Background:

• Intracapsular and condylar neck fractures pose significant challenges in maxillofacial surgery.
• Conventional surgical approaches may carry risks of facial nerve injury and aesthetic deformities.

Purpose of the Study:

• To introduce and evaluate a modified preauricular transparotid approach (MPTA) for treating intracapsular and condylar neck fractures.
• To compare the MPTA with the conventional submandibular approach.

Main Methods:

• A technical modification of the preauricular approach involving a superficial musculoaponeurotic system incision above the parotid gland.
• Retrograde dissection of the buccal branch of the facial nerve within the parotid gland.
• Open reduction and internal fixation in 6 patients with intracapsular and condylar neck fractures between January 2019 and December 2020.

Main Results:

• All surgeries were uneventful with no reported infections.
• Mean procedure duration was 85 minutes (range 75-115 minutes).
• One-year follow-up revealed stable occlusion, natural facial morphology, and adequate mandibular function in all patients.

Conclusions:

• The modified preauricular transparotid approach (MPTA) is highly suitable for intracapsular and condylar neck fractures.
• MPTA is associated with negligible morbidity regarding facial nerve damage, vascular injuries, and aesthetic outcomes.
• This technique provides a safe and effective alternative for managing complex facial fractures.