The use of the transparotid approach for surgical treatment of condylar fractures - Own experience.

AIM: To assess the results of surgical treatment of condylar fractures using the transparotid approach.

MATERIAL AND

METHODS

The transparotid approach was used in 38 patients with unilateral condylar fracture. In four cases a single 2.0 plate was used, in the latter - 3D plates were used. All the patients were subjected to control clinical examination including: occlusion, facial nerve function, mandibular movements, pain presence, subjective assessment of the scar aesthetics and the presence of salivary fistula or salivary cyst on the first day following surgery and after 1, 3 and 6 months. Control radiography of the mandible in at least two projections was made on the first day after surgery and after 3 months.

RESULTS

In 3 patients a partial paresis of the facial nerve was noticed followed by a spontaneous recovery 3 months postoperatively. In 2 patients acoustic effects, without pain in the temporomandibular joint of the fractured side were still present 6 months postoperatively. Plate fractures were found in two out of four patients operated on with single-plate technique. Loosening and displacement of a fixation screw occurred in 4 patients; in 3 cases it referred to a single 2.0 plate and in one, a Delta plate. Post-operation scar was accepted by all the patients.

CONCLUSION

The transparotid approach allows for direct visualisation of the fracture providing proper reduction and osteosynthesis, with a low risk of facial nerve paresis. Precise wound closure in layers, especially of the parotid capsule allows avoiding a salivary fistula.