Design And Analysis Of Mandibular Condylar Fracture Surgical Approach

Objective: By selecting different surgical approaches for patients with different types of condylar fractures and conducting statistical analysis of postoperative complications,the surgical methods with satisfactory postoperative efficacy for different fracture types were discussed,so as to provide theoretical basis and technical support for the selection of reasonable surgical approaches and treatment methods.Methods: A total of 43 patients(50 sides)who needed surgical treatment due to condylar fracture from September 2016 to September 2018 in the maxillofacial trauma.and orthognathic surgery ward of the affiliated stomatological hospital of Xinjiang Medical University were collected.Preoperative digital panoramic radiograph and/or CT of mandible were performed to determine the type of fracture.The cases were divided into four groups by surgical approach,namely,the preauricular approach group,the auricle marginal approach group,the retromandibular approach group and the submandibular approach group.Patients were followed up for more than 6 months after surgery,and their satisfaction with the surgical incision was investigated through outpatient review.Facial nerve injury and occlusal relationship were recorded,and statistical analysis was conducted.Result:Among the 43 patients(50 sides)who were followed up,18 sides of condylar fractures were treated via the preauricular approach,13 sides of condylar fractures were treated via the auricle marginal approach,11 sides of condylar fractures were treated via the retromandibular approach,and 8 sides of condylar fractures were treated via the submandibular approach.1.Facial nerve injury: postoperative facial nerve injury occurred in 17 sides,including 8 sides in the auricle marginal approach group(23.5%),with the highest facial nerve injury rate.Chi-square test was performed on the rates of the facial nerve injury in four groups,indicating that there were significant differences between the auricle marginal approach and retromandibular approach,between the auricle marginal approach and preauricular approach.2.Patient satisfaction: among the 43 patients(50 sides)with condylar fracture,44 sides were satisfied with the incision,with satisfaction rate of 88%,among which 12 sides were satisfied with the uricle marginal approach group,with satisfaction rate of 92.3% being the highest.Conclusion:Each surgical approach has different advantages.For the fracture of the condyle head and neck,it is recommended to use the auricle marginal approach and preauricular approach.For the fracture of the condyle base or lower position,the retromandibular approach can be used.