Postoperative complications associated with the retromandibular approach: a retrospective analysis of 118 subcondylar fractures.

PURPOSE

The purpose of this study was to evaluate the rate of complications associated with the retromandibular approach.

MATERIALS AND METHODS

The design of this research was a retrospective case-series study. Included were patients who 1) underwent open reduction and internal fixation of the condylar or subcondylar area through a retromandibular approach and 2) had a complete and available medical chart. Excluded were 1) patients treated endoscopically or by other approaches and 2) patients with preoperative facial paralysis. The data collected were age, gender, medical comorbidities, tobacco use, mechanism of injury, anatomic location, concomitant facial fractures, follow-up time, antibiotic protocol, and complications.

RESULTS

One hundred eight patients (81 male; 118 condyles; age, 13 to 82 yr; mean, 35.6 ± 15.8 yr) met the inclusion criteria. Six patients never returned for postoperative visits and the mean follow-up time for all other patients was 6.5 months (8 days to 5.5 years). Twenty-six cases (22%) of temporary paralysis and 1 case of permanent facial paralysis were noted. Eight patients (6.8%) had persistent partial facial paralysis at their last visit, but all had short postoperative follow-ups. Fourteen cases (11.9%) of infection, 4 salivary fistulas, 2 sialoceles, 1 case of Frey syndrome, and 2 seromas were observed.

CONCLUSION

The retromandibular approach is a safe method for the treatment of condylar process fractures and major complications are rare.