Transoral versus Extraoral Approach in the Management of Mandibular Angle Fracture: A Retrospective Study

Abstract

Introduction: Mandibular fractures are the most common of all maxillofacial fractures and almost one third of these have mandibular angle fractures. Restoration of anatomic form and the union of bone fragments is of utmost important during the management of mandibular angle fractures and several methods have been discussed in the literature. Aim: To compare the transoral and extraoral approaches for the management of mandibular angle fractures in terms of postoperative outcomes including the incidence of postoperative pain, infection, scarring mouth opening and facial nerve injury. Materials and Methods: This retrospective study was performed in the Department of Plastic Surgery, Father Muller Medical College and Hopsital, Mangalore, Karnataka, India, from January 2019 to December 2021. A total of 21 patients were divided into two groups; transoral (n=12) and extraoral (n=9), based on the type of approach used for surgery. The outcomes were assessed in both groups in terms of postoperative outcomes including the incidence of postoperative pain, infection, scarring, mouth opening and facial nerve injury. Data were statistically analysed using appropriate statistical tests. Results: Out of the 21 patients studied, one patient in the extraoral group developed postoperative surgical site infection. There was a statistically significant difference in duration of surgery and postoperative mouth opening (p-value=0.006) and a highly significant difference in postoperative pain (p-value<0.001) and scar (p-value<0.001) between the two methods, proving transoral approach as effective method. Conclusion: The transoral approach is a better approach for fixation and management of mandibular angle fractures, as compared to the extraoral approach.

Keywords

• facial nerve
• intermaxillary fixation
• maxillofacial fractures
• occlusion