2024 Volume 73 Issue 1 Pages 1-8
The retromandibular anterior trans-parotid （RAT） approach and a triangular-positioned double mini-plate osteosynthesis （TDO） technique have been reported from Innsbruck Medical University. This minimally invasive technique involves direct visualization of the condyle and is associated with lower incidence of facial palsy. A retrospective review was performed on the RAT approach and TDO technique conducted by a surgeon and team at two hospitals in Tokyo during a 3-year 10-month period. This technique was performed on 35 patients with 39 condylar fractures. Sixty-nine percent of cases were due to accidental fall, 17％ to traffic accidents, and 9％ to sports. Further, 92％ cases were condylar base fractures. Ninety-seven percent of cases achieved good occlusion. The mean maximum mouth opening was 49 ± 1.3mm. Postoperatively, facial palsy developed in three patients （7.7％）, and two of them developed Frey syndrome at approximately postoperative 30 months （5.1％）. All patients completely recovered within postoperative 3 months. One case each of salivary fistula, visible scar, and condylar resorption was found （2.6％）. No case of massive bleeding during surgery, hematoma, or TMJ pain after surgery was found. This technique could achieve good occlusion with low incidence of complications. and could contribute to the early social reintegration of patients.
