Open Reduction and Internal Fixation of Subcondylar Fracture by Retromandibular Transmasseteric versus Transparotid Approaches

Background: Fractures of the mandibular condyle result in displacement of the condyle and decrease the ramus height. There are several surgical approaches for open treatment of the fractures. Surgical approaches to the fractured mandibular condyle are broadly classified into intraoral and extraoral approaches. A retromandibular approach is the most commonly used for open reduction and internal fixation of such fractures. Objective: To compare the complications associated with a retromandibular transparotid approach with a retromandibular transmasseteric anterior parotid (TMAP) approach for their management. Methods: Twenty-four patients were included in this study and divided into two groups: Group A included the retromandibular TMAP and Group B retromandibular transparotid approach. The variables evaluated were operating time and facial nerve injury at one week, four weeks, and three months. Results: The mean age in groups A and B was 26.92 and 23.82 years, and there were 20 men and 4 women. The transparotid group showed a shorter incision time (13.8 min) compared to the transmasseteric group (26.3 min). The incidence of facial nerve injury was a single patient in the transparotid group and none in the TMAP group. The results did not show any significant difference in complications between the two approaches. Conclusions: The retromandibular transparotid and transmasseteric approaches are safe and effective methods in the management of subcondylar fractures of the mandible.