Experience of mandibular condyle fracture surgery via the transmasseteric anteroparotid approach

Abstract

In the surgical approach to condylar fractures, limited access and risk of injury to the facial nerve are the most common complications. We present the transmasseteric anteroparotid （TMAP） approach for condylar fractures, which was applied to one subcondylar fracture and two lower neck fractures in this study.
The incision was made along the tragus fold extending downward to the inferior margin of the ear lobe, followed by an incision parallel to the mandibular ramus. Dissection was performed anteriorly on the parotid fascia and was continued between the anterior edge of the parotid and the posterior edge of the masseter muscle, with careful retraction of the buccal branch of the facial nerve, leading to the condyle and the posterior border of the ramus. After reduction of the fracture line, the fragment was fixed with titanium plates.
No patient had postoperative facial nerve palsy or parotid fistula. Postoperative reduction status, occlusion, mouth opening, and cosmetic self-assessment were satisfactory. Although confirmation of these outcomes requires additional cases and a clinical comparative study, we suggest that the TMAP approach is an appropriate surgical technique for treatment of condylar fractures.