ĐƯỜNG TIẾP CẬN XUYÊN CƠ CẮN TRƯỚC TUYẾN MANG TAI TRONG PHẪU THUẬT GÃY LỒI CẦU XƯƠNG HÀM DƯỚI: KẾT QUẢ ĐIỀU TRỊ BƯỚC ĐẦU TẠI BỆNH VIỆN RĂNG HÀM MẶT TRUNG ƯƠNG VÀ BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Objectives: To evaluate the preliminary clinical outcomes of the transmasseteric anterior parotid (TMAP) approach for open reduction and internal fixation (ORIF) of mandibular condylar fractures.

Materials and Methods: A prospective descriptive study was conducted on 18 patients with mandibular condylar fractures requiring surgical treatment at Hanoi Central Odonto-Stomatology Hospital and Hanoi Medical University Hospital between July 2025 and July 2026. All patients underwent ORIF using the TMAP approach with individualized skin incisions according to fracture location. Outcome measures included intraoperative and postoperative complications; facial nerve function, assessed using the House-Brackmann grading system; maximal mouth opening; occlusal stability; postoperative computed tomography findings; and patient satisfaction.

Results: Among the 18 patients, males accounted for 94.4%, and road traffic accidents were the predominant cause of injury. No cases of facial nerve paralysis, postoperative hemorrhage, or sensory deficit in the parotid region were observed. One patient (5.6%) developed a salivary fistula, which resolved completely with conservative management. At the three-month follow-up, all patients achieved a maximal mouth opening greater than 35 mm with stable occlusion. Postoperative computed tomography demonstrated satisfactory anatomical reduction, restoration of ramus height and fracture angulation, with no evidence of hardware loosening or fixation failure.

Conclusions: The TMAP approach is a safe and effective surgical technique for mandibular condylar fractures, providing excellent exposure, minimizing facial nerve injury, and achieving favorable anatomical and functional outcomes.