Comparison between Preauricular Approach and Submandibular Risdon Approach for Managing Condylar Fractures

Abstract

Background:Concerning the fractures of the mandibular condylar process. Clinician's choice between surgical and conservative management remains controversial. To allow the accurate reduction of the fracture with anatomical considerations, the chosen treatment is the reduction of the fracture along with the fixation internally (ORIF) for fractured mandibular condyle.

Aims: The present clinical trial was aimed at evaluating and comparing the two most commonly used incisionby the Preauricular approach and submandibular Risdon approach.

Materials And Methods:The 20 study subjects were split randomly in two groups depending on the approach used.They were treated with the preauricular approach or the submandibular Risdon approach.Complications related to these surgical procedures were assessed intra-operatively as well as post-operatively. Damage to the facial nerve, haemorrhage, and scar perception was analyzed for 6 months post-operatively.

Results:Intraoperative haemorrhage was seen in two patients of the preauricular approach and 3 with submandibular Risdon approach. In none of the cases, the internal maxillary artery was seen.  In the preauricular approach, transparotid, transmassetric, preauricular, and marginal mandibular nerve was seen in 20% (n=2), 10% (n=1), 30% (n=3), and 20% (n=2) cases respectively. In the submandibular Risdon approach transparotid artery was encountered in 1 case i.e., 10% (n=1) and marginal mandibular branch in 20% subjects (n=2).

Conclusions:Preauricular, as well as submandibular approaches, have equally good outcomes in terms of intra-operative as well as postoperative complications. Significant improvement with the encountered complications, mouth opening, the mandibular movements at 6 months recall interval.