Which is the fastest and safest approach? A comparison of time and complications of transparotid and anteroparotid retromandibular approach in management of mandibular subcondylar fractures: A prospective randomized controlled trial.

IF 2.2 3区医学 Q2 Dentistry Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2025-01-14 DOI:10.1016/j.jormas.2025.102235

Pareeksit Bagchi, Sunil Sidana, Padmakar Baviskar, Srivalli Natarajan, Suraj Ahuja, Ruchita Balkawade

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Abstract

Introduction: Mandibular condylar fractures are among the most common facial fractures and its incidence has been rising since the past few decades. Although various approaches for management of mandibular condylar fractures have been described in literature there is a gap in the published literature when it comes to comparison of these approaches. There have only been a handful of studies which have compared use of Retromandibular Transparotid against Retromandibular anteroparotid approach in management of mandibular condylar fractures with conflicting results. The aim of this study was to aid in decision making regarding the choice of approach between the Retromandibular Transparotid and Anteroparotid Transmasseteric approach based on the ease of surgical access and incidence of complications.

Materials and methods: A total of 24 patients were registered in the study under two treatment groups, Transparotid (Group A) and Anteroparotid (Group B). Data collection was done by a single blinded observer for measurement of exposure time, facial nerve weakness, facial oedema, presence of a sialocele, presence of a parotid fistula (and presence of various complications).

Results: The average time required for exposure of fracture site in group A was 11 min ± 2.73 min and in group B was 9 min ±1.91 min. Facial nerve injury (Grade III House Brackmann scale) was noted in one patient in group A. There was no significant difference in quality of reduction, occlusion and mandibular mobility.

Conclusion: The results of this study indicate that the rate of complications and time required to access the fracture site was comparable in both the approaches. It can be said that both the anteroparotid and transparotid approaches are reasonably safe and convenient in management of mandibular condylar fractures.

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哪一种是最快最安全的方法？一项前瞻性随机对照试验：经腮腺和前腮腺下颌后入路治疗下颌髁下骨折的时间和并发症的比较。

简介：下颌髁骨折是最常见的面部骨折之一，其发病率在过去的几十年里一直在上升。虽然文献中描述了各种治疗下颌髁突骨折的入路，但在发表的文献中对这些入路的比较存在空白。只有少数的研究比较了下颌后经腮腺入路与下颌后前腮腺入路在治疗下颌髁突骨折中的应用，结果相互矛盾。本研究的目的是根据手术进入的便便性和并发症的发生率，帮助在下颌后经鼻窦入路和前颈动脉经咬肌入路之间做出选择的决策。材料和方法：共有24例患者登记入组，分为经腮腺（A组）和前腮腺（B组）两个治疗组。数据收集由单盲观察者完成，测量暴露时间、面神经衰弱、面部水肿、涎腺囊肿、腮腺瘘（以及各种并发症）的存在。结果：A组骨折部位暴露平均时间为11分2.73分钟，B组为9分1.91分钟。a组1例患者面神经损伤（House Brackmann分级III级），复位质量、咬合质量和下颌活动能力无显著差异。结论：本研究结果表明，两种入路的并发症发生率和到达骨折部位所需的时间相当。可见，前腮腺入路和经腮腺入路治疗下颌髁突骨折都是比较安全、方便的。简介：下颌髁骨折是最常见的面部骨折之一，其发病率在过去的几十年里一直在上升。虽然文献中描述了各种治疗下颌髁突骨折的入路，但在发表的文献中对这些入路的比较存在空白。只有少数的研究比较了下颌后经腮腺入路与下颌后前腮腺入路在治疗下颌髁突骨折中的应用，结果相互矛盾。本研究的目的是根据手术进入的便便性和并发症的发生率，帮助在下颌后经鼻窦入路和前颈动脉经咬肌入路之间做出选择的决策。材料和方法：共有24例患者登记入组，分为经腮腺（A组）和前腮腺（B组）两个治疗组。数据收集由单盲观察者完成，测量暴露时间、面神经衰弱、面部水肿、涎腺囊肿、腮腺瘘（以及各种并发症）的存在。结果：A组骨折部位暴露平均时间为11分钟±2.73分钟，B组为9分钟±1.91分钟。a组1例患者面神经损伤（House Brackmann分级III级），复位质量、咬合质量和下颌活动能力无显著差异。结论：本研究结果表明，两种入路的并发症发生率和到达骨折部位所需的时间相当。可见，前腮腺入路和经腮腺入路治疗下颌髁突骨折都是比较安全、方便的。

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来源期刊

Journal of Stomatology Oral and Maxillofacial Surgery Dentistry-Oral Surgery

CiteScore

2.20

自引率

9.10%

发文量

305

期刊介绍： J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.