Comparison of Preauricular Versus Retromandibular Approach in the Management of Mandibular Condyle Fractures

Objective: To compare the rate of complications encountered on using different incision to access the fracture site for the open reduction and internal fixation of condylar fractures.

Setting: Department of Oral & Maxillofacial Surgery, Institute of Dentistry, LUMHS

Subject and Methods: A total 64 patients with unilateral condyle fractures were randomly treated into two groups. Thirty two patients in group A were treated with preauricular incision and 32 were treated with Retro mandibular incision. Patients were followed for period of upto six months for assessment of complications of facial nerve injury such as: salivary fistula and hypertrophic scar formation.

Results: The average age of the patients was 31.66±9.40 years. Rate of facial nerve palsy was significantly high in group A than group B (18.75% vs. 6.25%; p=0.021) similarly, the rate of salivary fistula and scar formation were also significantly high in group A as compare to groups B (12.5% vs. 1.56% p=0.026) and (14.06% vs. 1.56%;p=0.013) respectively.

Conclusion: The retromandibular approach is more suitable for the lower level condylar neck fractures, providing a direct visual field and wide, straight-line access for implant fixation at this region.