In 2005 experimental work was published about the successful surgical management of fractures of the condylar head through a retroauricular approach. There were two reports in German, and later publications have not mentioned this route to open reduction and internal fixation of such fractures. The approach was studied in Germany but was poorly described and illustrated; later reports in English do not mention this route to the mandible. The aim of this study was to illustrate the retroauricular transmeatal approach, and briefly to review current surgical approaches to the mandibular skeleton and their technical variants. We exposed the mandibular skeleton by a retroauricular transmeatal route with transection of the external ear, dissection of the parotid gland, isolation of the retromandibular vein, and protection of the frontal branch of the facial nerve and the auriculotemporal nerve within the substance of the anteriorly retracted flap. Although we cannot draw any significant conclusions, the retroauricular transmeatal approach ensures extremely low risk of injury to the facial nerve, and leaves an invisible scar. The morbidity is low in terms of facial nerve lesions, vascular injuries, aesthetic deformity, auditory stenosis, salivary fistulas, sialocele and Frey syndrome. We think that further prospective clinical trials are needed better to assess and eventually develop this approach.
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- Small fragment screws vs plate osteosynthesis in condylar head fractures.Mund Kiefer Gesichtschir. 2005; ([in German]): 80-88
- Stability of osteosyntheses for condylar head fractures in the clinic and biomechanical simulation.Mund Kiefer Gesichtschir. 2004; 8 ([in German]. Erratum: Mund Kiefer Gesichtschir 2004;8:264): 63-74
- Retroauricular transmeatal approach to manage mandibular condylar head fractures.J Craniofac Surg. 2011; 22: 641-647
- Fractures of the mandibular condyle: approaches and osteosynthesis.Eberl Print GmbH, Immenstadt2010
- Transoral approach to fractures of the mandible.Laryngoscope. 1987; 97: 4-6
- Endoscopic repair of mandibular subcondylar fractures.Plast Reconstr Surg. 1998; 101: 437-441
- The mentalis muscle: an essential component of chin and lower lip position.Plast Reconstr Surg. 2000; 105: 1213-1215
- Submandibular approach for open reduction of condylar fracture.Oral Surg Oral Med Oral Pathol. 1964; 17: 152-157
- Retromandibular approach for reduction and fixation of mandibular condylar fractures: a clinical experience.Int J Oral Maxillofac Surg. 2009; 38: 835-839
- Transmasseteric anteroparotid approach for open reduction and internal fixation of condylar fractures.Br J Oral Maxillofac Surg. 2005; 43: 57-60
- Surgical reduction and fixation of intracapsular condylar fractures. A follow up study.Int J Oral Maxillofac Surg. 1998; 28: 191-194
- Modified preauricular approach and rigid internal fixation for intracapsular condyle fracture of the mandible.J Oral Maxillofac Surg. 2010; 68: 1578-1584
- Facial rhytidectomy approach for treatment of posterior mandibular fractures.J Craniomaxillofac Surg. 1997; 25: 9-14
- An anatomical comparison of Blair and facelift incisions for parotid surgery.Clin Otolaryngol. 2006; 31: 531-534
- Classification of facial translocation approach to the skull base.Otolaryngol Head Neck Surg. 1995; 112: 579-585
Published online: September 19, 2011
Accepted: August 20, 2011
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.