Feasibility of the preauricular transparotid approach in open reduction and internal fixation of intracapsular mandibular condyle fracture

Abstract

Mandibular condyle fractures pose surgical challenges owing to their proximity to the facial nerve and the complex temporomandibular joint anatomy. Traditional approaches limit exposure and hinder effective fracture management. The preauricular transparotid approach is a potential alternative. We aimed to assess the feasibility of this approach and the postoperative complications.

A retrospective analysis of 45 patients who underwent open reduction/internal fixation (OR/IF) for intracapsular condylar fractures using a preauricular transparotid approach was conducted. Patient demographics, surgical procedures, radiological assessments, and postoperative complications were analyzed.

The preoperative computed tomography analysis revealed the fractured segment's location: 17.0 ± 2.6 mm anteriorly, 24.0 ± 4.0 mm medially, and 17.8 ± 3.7 mm inferiorly from the remaining condyle end. A cubic space of 17–24 mm from the condylar stump is necessary to reach the fractured segment end. Postoperative facial nerve weakness occurred in 14 patients but resolved within 4.5 weeks. At 5.5 months of follow-up, the mean interincisional mouth opening measured 40.5 ± 5.1 mm, without malocclusion.

The approach enhances visualization, facilitates precise fixation, and results in inconspicuous scarring during OR/IF of intracapsular condylar fractures. It requires careful surgical techniques and increases the risk of transient facial nerve weakness. Further research should compare its outcomes with those of traditional approaches and optimize surgical outcomes.