clinical assessment of retromandibular antero-parotid approach for reduction of mandibular subcondylar fractures: report of 60 cases and review of the literature

This study assessed the efficacy of the retromandibular antero-parotid approach for open reduction and internal fixation (orif) of subcondylar fractures. sixty patients with the mean age of 31.03 years underwent surgical reduction with a 20-25mm incision in the retromandibular area with an antero-parotid transmasseteric approach. all patients were followed between 6 to 12 months. at the end of the first week, six patients exhibited postoperative malocclusion. at the next visits, all patients had optimal occlusion. maximal interincisal opening (mio) of 56 patients (93.3%) was >37mm, and only four patients (6.7%) had mio<37mm. in three patients (5%), weakness of the buccal branch of the facial nerve was noticed postoperatively. no salivary gland complications were seen. the surgical scar was hardly noticeable. retromandibular access with transmasseteric antero-parotid approach is the technique of choice for treatment of high- and low-level subcondylar fractures with adequate visibility and direct access to the condylar area.