Evaluation of transmasseteric anteroparotid approach to mandibular subcondylar fractures

Authors

  • Ahmed Mohamed Hosni Mohamed Lecturer of Oral and Maxillofacial Surgery Department, Faculty of Oral and Dental Medicine, Cairo boys, Al-Azhar University, Egypt
  • Ahmed Mohammed Mostafa Elfar Lecturer of Oral and Maxillofacial Surgery Department, Faculty of Oral and Dental Medicine, Cairo boys, Al-Azhar University, Egypt
  • Mustafa G. Khallaf Lecturer of Oral and Maxillofacial Surgery Department, Faculty of Oral and Dental Medicine, Cairo boys, Al-Azhar University, Egypt
  • Ahmed Mohammed Saaduddin Sapri Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Egypt
  • Mohamed R. Omar Lecturer of Oral and Maxillofacial Surgery Department, Deraya University, Egypt
  • Nermine Ramadan Mahmoud Associated Professor of oral and maxillofacial surgery, Oral Surgery Department, Faculty of Dentistry, October 6 University. 6th of October City, Giza Governorate, Egypt

Keywords:

P-TMAP approach, condylar fractures, mandibular

Abstract

Introduction: Different techniques employing, retromandibular, preauricular, or submandibular incisions have been used for the treatment of subcondylar and condylar fractures. The approaches listed above may lead to some disadvantages which include limited visibility, facial nerve damage, and problems associated with the parotid gland. Study objective: Clinically, case studies were performed to evaluate the efficacy of P-TMAP approach for open reduction and internal fixation (ORIF) of condylar and subcondylar fractures. The study comprised of 7 people within the condylar and subcondylar fractures group who were treated by ORIF. We analyzed the administrative hours, accessibility, and medical review on perioperative complications. A CT scan was done to confirm the site where condylar fractures were reduced. Findings: Visibility and accessibility were good. The patients underwent careful anatomical alignment and stabilization. These reported complications were limited and only lasted temporarily. The facial nerve (buccal branch) palsy of one patient was the only adverse event that was reported, and it resolved spontaneously in 3 months. No case of Frey's syndrome and sialocele was spotted. Conclusion: The P-TMAP method is an effective way of access for closing the reduction and fixing the condylar fractures. It facilitates retention, transference, relocation, and fixation of the condyle. 

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References

Maclennan W. Consideration of 180 cases of typical fractures of the mandibular condylar process. Br J Plast Surg. 1952; 5(2):122–8.

Ellis E, Throckmorton G. Treatment of mandibular condylar process fractures: biological considerations. J Oral Maxillofac Surg. 2005; 63(1):115-34.

A. Croce. Transparotid approach for mandibular condylar neck and subcondylar fractures, Acta Otorhinolaryngologica Italica, 2010; 30:303-309.

Kanno T, Sukegawa S, Furuki Y. Our treatment strategy for mandibular condylar fracture-retromandibular approach vs intraoral approach. Jpn J Oral Maxfac Surg. 2009; 55:58.

Haug R, Assael L. Outcomes of open versus closed treatment of mandibular subcondylar fractures. J Oral Maxillofac Surg. 2001; 59(4):370-5.

Neff A, Kolk A, Deppe H, Horch H. New aspects for indications of surgical management of intra-articular and high temporomandibular dislocation fractures. Mund Kiefer Gesichtschir 1999; 3:24-9.

Özkan H, Sahin B, Görgü M, Melikoglu C. Results of transmasseteric anteroparotid approach for mandibular condylar fractures. J Craniofac Surg. 2010; 21(6):1882–3.

Schneider M, Eckelt U. Open versus closed treatment of fractures of the mandibular condylar process–a prospective randomized multi-centre study. J Cranio-Maxillofac Surg 2006; 34, 306–314.

Valiati R, Ibrahim D, Abreu M, Heitz C, de Oliveira R, Pagnoncelli R et al. The treatment of condylar fractures: to open or not to open? A critical review of this controversy. Int J Med Sci. 2008 Jan; 5(6):313–8.

Choi BH, Yoo JH. Open reduction of condylar neck fractures with exposure of the facial nerve. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88:2926.

Silverman S. A new operation for displaced fractures at the neck of the mandibularcondyle. Dent Cosm. 1925; 67:876–7.

Steinhauser E. Interventions on the articular process by the oral route. Dtsch Zahnarztl Z. 1964; 19:694–700.

Rozeboom A, Dubois L, Bos R, Spijker R, de Lange J. Open treatment of condylar fractures via extraoral approaches: a review of complications. J Craniomaxillofac Surg 2018; 46:1232-40.

Ellis E 3rd, McFadden D, Simon P, Throckmorton G. Surgical complications with open treatment of mandibular condylar process fractures. J Oral Maxillofac Surg, 2000 Sep; 58(9):950-8. doi: 10.1053/joms.2000.8734. PMID: 10981974.

Kempers KG, Quinn PD, Silverstein K. Surgical approaches to mandibular condylar fractures: A review. J Craniomaxillofac Trauma 1999;5:2530

Van Hevele J, Nout E. Complications of the retromandibular transparotid approach for low condylar neck and subcondylar fractures: a retrospective study. J Korean Assoc Oral Maxillofac Surg, 2018 Apr; 44(2):73-78. doi: 10.5125/jkaoms.2018.44.2.73. Epub 2018 Apr 25. PMID: 29732312; PMCID: PMC5932275.

Vesnaver A, Gorjanc M, Eberlinc A, Dovsak DA, Kansky AA. The periauricular transparotid approach for open reduction and internal fixation of condylar fractures. J Craniomaxillofac Surg, 2005 Jun; 33(3):169-79. doi: 10.1016/j.jcms.2005.01.008. Epub 2005 Apr 21. PMID: 15878517.

Nikolić ŽS, Jelovac DB, Šabani M, Jeremić JV. Modified Risdon approach using periangular incision in surgical treatment of subcondylar mandibular fractures. Srp Arh Celok Lek, 2016 Jul-Aug; 144(7- 8):391-6. PMID: 29652446.

Nam SM, Lee JH, Kim JH. The application of the Risdon approach for mandibular condyle fractures. BMC Surg, 2013 Jul 6; 13:25. doi: 10.1186/1471-2482-13- 25. PMID: 23829537; PMCID: PMC3708819.

Wilson AW, Ethunandan M, Brennan PA. Transmasseteric anteroparotid approach for open reduction and internal fixation of condylar fractures. Br J Oral Maxillofac Surg 2005; 43:5760.

Bernstein L, Nelson RH. Surgical anatomy of the extra parotid distribution of the facial nerve. Arch Otolaryngol 1984; 110:17783.

Trost O, Abu El Naaj I, Trouilloud P, Danino A, Malka G. High cervical transmasseteric anteroparotid approach for open reduction and internal fixation of condylar fracture. J Oral Maxillofac Surg 2008;66:201 4

Trost O, Trouilloud P, Malka G. Open reduction and internal fixation of low subcondylar fractures of mandible through high cervical transmasseteric anteroparotid approach. J Oral Maxillofac Surg 2009;67:244651

Lutz JC, Clavert P, WolframGabel R, Wilk A, Kahn JL. Is the high submandibular transmasseteric approach to the mandibular condyle safe for the inferior buccal branch? Surg Radiol Anat 2010;32:9639

Gilliland J, Ritto F, Tiwana P. (n.d.). Complications of the transmasseteric anteroparotid approach for subcondylar fractures: A retrospective study. Manuscript submitted for publication, Oklahoma University Health Science Center

Published

27-10-2021

How to Cite

Mohamed, A. M. H., Elfar, A. M. M., Khallaf, M. G., Sapri, A. M. S., Omar, M. R., & Mahmoud, N. R. (2021). Evaluation of transmasseteric anteroparotid approach to mandibular subcondylar fractures. International Journal of Health Sciences, 5(S2), 1367–1376. Retrieved from https://sciencescholar.us/journal/index.php/ijhs/article/view/14827

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