Study on the application of modified auriculotemporal incision combined with submaxillary incision in intracapsular condylar fracture

Objective To investigate and discuss the efficacy of modified auriculotemporal incision combined with submaxillary incision in rigid internal fixation of intracapsular condylar fractures. Methods Total 15 patients with intracapsular condylar fractures in the Department of Oral and Maxillofacial Surgery at the First Affiliated Hospital of Bengbu medical college from January 2017 to June 2019 were selected, including 18 sides, 3 of which were treated conservatively, the rest were treated by modified auriculotemporal incision combined with submaxillary incision. The patients were followed up for 6-12 months to observe whether there were symptoms of facial nerve injury, whether there were changes of mouth opening degree and/or mouth opening type, whether there was temporomandibular joint bounce, whether there was loosening and absorption of double cortical screw. Results Total 14 patients had no facial paralysis and salivary fistula, 1 patient had a short disappearance of frontal striae, and was treated with rat nerve growth factor(2 mL of water for injection, intramuscular injection, once a day, once a branch, two courses) to restore normal within 3 months. Total 15 patients had a good restoration of occlusal system and mouth opening degree(foot measurement mouth opening degree ≥3 cm). There was no joint bounce, open deflection, malocclusion and other complications. After operation, CT showed that the double cortical screw was fixed in place without looseness, and the fracture end was restored well. After 6 months of operative, three-dimensional CT(horizontal and coronal) showed that condylar head and joint plate location relationship was good, no obvious articular adhesion, condylar head absorption, etc. Conclusion The modified auriculotemporal incision combined with submaxillary incision in rigid reduction and internal fixation of intracapsular condylar fractures has the advantages of clear visual field exposure, less facial nerve injury, less damage to articular disc and articular cartilage, which can provide certain reference for the surgical treatment of intracapsular condylar fractures.