Transparotid and Submandibular Approaches to Condylar Fracture Repair: Comparison of Outcomes.

Abstract

Introduction: Although condylar fractures are common in the field of oral and maxillofacial surgery, the approach to their treatment is not straightforward. Multiple soft-tissue approaches are available, but it is unclear which yields the best outcomes. In this retrospective study, we aimed to determine whether a transparotid or submandibular soft-tissue approach to treating condylar fractures yields better outcomes.

Methods: This study consisted of a retrospective chart audit and an in-person assessment. The chart audit involved all patients who presented to the Queen Elizabeth II Health Sciences Centre (Halifax) between 2012 and 2022 with condylar fracture treated with open reduction and internal fixation. The chart review assessed each patient's maximum interincisal opening, paresthesia, nerve function, infection and occlusion. The in-person assessment further assessed scar satisfaction, overall patient satisfaction with the treatment process and cosmetic results, and the incidence of Frey syndrome. Outcomes with the transparotid and submandibular approaches were compared using the Mann-Whitney U test for continuous variables and the χ² or Fisher exact test for categorical variables, with significance level set at p < 0.05 (2-tailed).

Results: Data were collected from the charts of 32 patients who met the eligibility criteria during the study period; 14 of these patients also underwent an in-person assessment (at 1 to 7 years after the surgery). Statistical analysis of data from the chart audit and in-person assessment suggested no difference between the 2 approaches in terms of surgical outcomes after condylar fractures.

Conclusion: The optimal approach for treatment of condylar fractures should be determined individually, based on the surgeon's preference, fracture location and extent of the fracture.