Complications of the retromandibular transparotid approach for low condylar neck and subcondylar fractures: a retrospective study

J Korean Assoc Oral Maxillofac Surg. 2018 Apr;44(2):73-78. doi: 10.5125/jkaoms.2018.44.2.73. Epub 2018 Apr 25.

Abstract

Objectives: The goal of this study was to evaluate the rates of complications, morbidity, and safety with the transparotid approach.

Materials and methods: A retrospective study was conducted and consisted of 53 surgically treated patients in the past five years for low condylar neck and subcondylar fractures. Only patients with malocclusion and who underwent open reduction with internal fixation with the retromandibular transparotid approach were included. The examined parameters were postoperative suboptimal occlusion, deflection, saliva fistula, and facial nerve weakness.

Results: Fifty-three patients had an open reduction with internal fixation on 55 sides (41 males, 77.4%; mean age, 42 years [range, 18-72 years]). Four patients (7.5%) experienced transient facial nerve weakness of the marginal mandibular branch, but none was permanent. Four patients had a salivary fistula, and 5 patients showed postoperative malocclusion, where one needed repeat surgery after one year. One patient showed long-term deflection. No other complications were observed.

Conclusion: The retromandibular transparotid approach is a safe procedure for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.

Keywords: Mandibular fractures; Maxillofacial surgery; Open fracture reduction; Parotid gland.