Comparison of Preauricular Approach Versus Retromandibular Approach in Management of Condylar Fractures

Objectives: Surgical treatment of patients with multiple mandibular fractures involving condylar segments may be a difficult proposition for a maxillofacial surgeon. These fractures can be double or triple fractures of the lower mandible and can also be associated with other fractures of the face. While many authors have suggested that the conventional approach to reducing and stabilizing a mandibular symphysis / para-symphysis fracture is appropriate before addressing a fractured condyle, there is another school of thought that suggests that the condylar segment should be reduced and repaired first. This article aims to review the results of operations where the reduction and fixation of a fractured condyle is performed prior to other associated mandible fractures, and to explore the effectiveness of various surgical methods including preauricular and retromandibular proposed in this case. Place and Duration: In the Oral and Maxillofacial surgery department of Faryal Dental College, Lahore for two-years duration from Jan 2018 to Jan 2020. Material and methods: The study included 60 surgically treated patients with multiple mandible fractures (double / triple), including the condyle component. For treatment of the fractured condylar segments, the preauricular and retromandibular (anterior parotid-transmasseteric) approach was used. Results: Condyle fracture was the first segment to be managed during sequencing of surgical treatment, regardless of the method used. First, good reduction and stabilization have been achieved with limited complications in treating a condyle fracture. Conclusion: While it is the surgeon's prerogative to sort multiple mandible fractures, addressing the condylar segment first provides the operator with a viable alternative to the conventional technique. Key words: condylar fractures, multiple mandibular fractures, preauricular approach, retromandibular approach