ĐÁNH GIÁ HIỆU QUẢ ĐƯỜNG MỔ TRƯỚC TAI XUYÊN TUYẾN MANG TAI TRONG PHẪU THUẬT KẾT XƯƠNG GÃY LỒI CẦU XƯƠNG HÀM DƯỚI DO CHẤN THƯƠNG TẠI BỆNH VIỆN QUÂN Y 175

Abstract

Objective: To evaluate the effectiveness of the preauricular transparotid approach in open reduction and internal fixation of mandibular condylar fractures due to trauma at Military Hospital 175.

Subjects and Methods: The study included 32 patients diagnosed with mandibular condylar fractures indicated for open reduction and internal fixation via the preauricular transparotid approach at Military Hospital 175 from January 2021 to June 2025.

Results: The male-to-female ratio was 1.67:1. A majority of patients (68.8%) were of working age (18–39 years), with a mean age of 29.63 ± 11.8 years. The most common cause of injury was traffic accidents (78.1%). Condylar neck fractures accounted for the majority of cases (71.9%). Immediately postoperatively, 84.4% of patients achieved satisfactory occlusion. The majority (62.5%) attained a maximal mouth opening of over 4 cm. Mild postoperative pain (VAS scale) was reported by 93.8% of patients. Complications included facial nerve branch injury in 3 cases, postoperative sialocele in 3 cases, and postoperative bleeding in 1 case. At 6-month follow-up, 93.8% of patients demonstrated stable occlusion, with only 2 patients exhibiting mild malocclusion (open bite involving 1–3 teeth). A maximal mouth opening >4 cm was observed in 84.4% of cases. Scar healing was cosmetically acceptable in 87.5% of patients. Only 1 patient had facial nerve branch involvement. All cases showed satisfactory bone healing on radiographs. No cases of parotid fistula or Frey’s syndrome were recorded.

Conclusion: The preauricular transparotid approach offers multiple advantages in the management of mandibular condylar fractures, including direct access to the fracture site, reduced need for extensive dissection, minimized tissue trauma, and favorable surgical exposure for reduction and fixation. The incision follows the natural skin crease, thus minimizing visible scarring. However, the technique requires a skilled surgeon to avoid complications such as facial nerve injury and parotid fistula formation.