Comparison between endoscopically assisted transoral and high perimandibular approaches for the surgical management of condylar fractures: A retrospective study

Objective

This study aimed to compare the endoscopically assisted transoral approach (EATA) and high perimandibular approach (HPMA) for mandibular condylar fractures.

Methods

We conducted a retrospective study on patients who underwent open reduction and internal fixation using the EATA or HPMA between March 2013 and February 2023 and were followed up for > 6 months. The primary predictor variables were the surgical approach, including the EATA and HPMA. The outcome variables were postoperative mandibular condition, including maximum interincisal opening, occlusion and condylar pain, anatomical reduction, and complications. Other predictive variables were patient characteristics and perioperative fracture conditions. Statistical analyses were performed by comparing patients treated with the EATA and HPMA.

Results

Seventeen and 14 patients who were treated with the EATA and HPMA, respectively, were eligible for this study. Radiological assessments showed that the anatomical reduction in patients treated with the HPMA was significantly better than in those treated with the EATA. Notably, four patients experienced trismus after the EATA and none after the HPMA. One patient experienced malocclusion after the EATA; however, none experienced malocclusion after the HPMA. However, the differences in these mandibular condition between the EATA and HPMA groups were not significant. None of the patients experienced transient or permanent facial nerve palsy.

Conclusions

Significant differences in anatomical reduction between patients treated with the EATA and HPMA are observed; however, the difference in postoperative mandibular condition is not significant between the two approaches. It is essential to choose the appropriate approach based on a thorough preoperative evaluation.