Minimal Incision Approach for Condyle Fracture Treatment

Abstract

Introduction: Surgical treatment of condylar neck fractures requires an extraoral approach when, due to the degree of difficulty of the fracture, an intraoral approach or an endoscopically supported treatment is not possible. In contrast to the cosmetically more favorable oral approach, extraoral approaches offer a better overview of the operating field and thus an easier fracture repositioning and osteosynthetic treatment. In 2007, Marti et al. described a minimal pre- and retroauricular incision with no extension to the hair-bearing skin and which aimed to improve the parotidectomy approach.

Materials and methods: We present two cases in which minimal incision was used as a surgical approach for treatment of the condylar neck.

Discussion: Using the minimal incision, we were able to access the condylar neck. This type of approach as well as having the advantages of an open approach makes it possible to conceal the scar in the periauricular region and reduce the likelihood of salivary fistula.

Keywords: Mandibular condyle; Mandibular fracture; Surgical approach; Surgical treatment.

Fig. 1

Case 1: the operative path of the minimal incision is marked around the earlobe. The lower horizontal line marks the incision used for the classic transparotid approach, while the upper line traces the posterior border of the mandibular ramus

Fig. 2

Case 1: surgical field obtained using the minimal incision approach. Osteosynthesis of the condylar fracture using 2 2.0-mm titanium plates. The caudal part of the approach reveals a preserved greater auricular nerve

Fig. 3

Case 1: a panoramic radiograph of the postoperative phase: the image shows the hybrid system used for intermaxillary fixation and to guide postoperative occlusion. Two 2.0-mm plates used for osteosynthesis in the left condyle and a 2.0-mm plate for osteosynthesis in the right condyle; b, c appearance of the scars 1 year postoperatively