Retromandibular approach for reduction and fixation of mandibular condylar fractures: a clinical experience.

This study evaluated the efficiency and safety of a retromandibular approach to reduce and fix displaced condylar fractures. The study group included 31 patients who had undergone surgery for 35 condylar fractures (8 bilateral, 23 unilateral). Consultants and residents had performed the procedure. Inclusion criteria were: patient's choice for open reduction and fixation; displaced unilateral condylar fractures with occlusal derangement; bilateral condylar fractures with anterior open bite. Restriction of lateral movement towards the unaffected side was observed preoperatively in all cases taken up. There was a difference in the lateral movements towards the fractured side (mean 7.2) and unaffected side (mean 4.2) during the first postoperative review. Functional occlusion identical to the preoperative occlusion and good reduction of the condyles was noted in all cases. Facial nerve was encountered in 6 cases (17%) intraoperatively. There was one case (3%) of temporary facial nerve weakness, which resolved within 2 weeks. There was no permanent facial nerve damage in any patient. The retromandibular-transparotid approach seems to be a safe and efficient method for reduction and internal fixation of condylar fractures with little or no risk to the branches of facial nerve.