Outcomes of the non-endoscopic transoral approach to subcond
The transoral approach (TRA) to subcondylar fractures without any endoscopic or transbuccal assistance is not a common technique.

The purpose of this study was to measure and compare the quality of open reduction and internal fixation (ORIF) between the TRA and the retromandibular approach (RMB), including types and frequencies of postoperative complications.

In the retrospective cohort study, researchers enrolled a sample of patients with a displaced subcondylar mandible fractures treated by ORIF. The predictor was the approach mode: TRA or RMB. In postoperative computed tomography (CT) data sets, they measured the angles of the condylar process in relation to references: i) midline, ii) lateral ramus border, and iii) ramus posterior border.

The primary outcome variable was the reduction outcome, which was calculated as the difference between the total of all angles of the operated side and the non-affected side. Secondary outcomes were postoperative complications extracted from patients' files. Other variables were age, gender, number of plates, operation time, and a modified AO trauma score. In bivariate analysis, they compared the outcome between both groups.

Sixty-four patients were included in the total, with TRA performed in 50%. Patients with TRA were younger, and the trauma score was lower. Reduction outcomes remained comparable between both techniques. Complication rates were similar, although facial nerve palsy was absent for TRA.

Journal of Oral and Maxillofacial Surgery
Source: https://doi.org/10.1016/j.joms.2021.07.026