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Background <p>Condylar neck fractures, especially with comminution or dislocation, often require surgical intervention, with extraoral approaches being more common. However, a lack of consensus exists regarding the optimal surgical method. This study compares clinical outcomes and complication rates between retromandibular and transoral approaches.</p> Methods <p>Retrospective data collection involved clinical records, comparing the two different approaches. Fracture classification followed Spiessl and Schroll as well as the AOCMF classification. Statistical analysis was performed with SPSS including descriptive analysis and Chi-square tests for associations. Surgical times were assessed using the Mann–Whitney <i>U</i> test.</p> Results <p>The analysis involved 74 patients, comprising 78.4%&#xa0;(<i>n</i> = 58)&#xa0;males and 21.6%&#xa0;(<i>n</i> = 16) females with a mean age of 41.65&#xa0;years (SD: 18.06). Thirteen (36.11%) of 36 patients who underwent transoral surgery and 18 (47.37%) of 38 patients who underwent retromandibular transparotid surgery experienced early complications. Specific complications like salivary fistulas and facial nerve palsies were unique to the extraoral group. The differences did not reach a level of significance.</p> Conclusion <p>The transoral approach emerges as a suitable method for managing fractures located in the condylar neck and base, given its lower complication rate and comparable surgical times.</p>

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Retrospective Comparison of the Transoral and the Retromandibular Approach for Condylar Base and Neck Fractures

  • 期刊论文

  • 发表日期：

    2025年6月4日

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  • L. Brescius,
  • E. Grau,
  • A. K. Sander,
  • D. Halama,
  • R. Zimmerer,
  • N. C. Pausch,
  • M. T. Neuhaus

摘要

Background

Condylar neck fractures, especially with comminution or dislocation, often require surgical intervention, with extraoral approaches being more common. However, a lack of consensus exists regarding the optimal surgical method. This study compares clinical outcomes and complication rates between retromandibular and transoral approaches.

Methods

Retrospective data collection involved clinical records, comparing the two different approaches. Fracture classification followed Spiessl and Schroll as well as the AOCMF classification. Statistical analysis was performed with SPSS including descriptive analysis and Chi-square tests for associations. Surgical times were assessed using the Mann–Whitney U test.

Results

The analysis involved 74 patients, comprising 78.4% (n = 58) males and 21.6% (n = 16) females with a mean age of 41.65 years (SD: 18.06). Thirteen (36.11%) of 36 patients who underwent transoral surgery and 18 (47.37%) of 38 patients who underwent retromandibular transparotid surgery experienced early complications. Specific complications like salivary fistulas and facial nerve palsies were unique to the extraoral group. The differences did not reach a level of significance.

Conclusion

The transoral approach emerges as a suitable method for managing fractures located in the condylar neck and base, given its lower complication rate and comparable surgical times.