Purpose: Comparing the transparotid approach versus the transmasseteric antroparotid approach in management of condylar
neck fractures regarding the facial nerve affection, TMJ function, reduction angulation, duration of the surgery and patient
satisfaction with the scar.
Materials and Methods: Twenty patients with condylar neck fracture were randomly divided into two equal groups.
Retromandibular transparotid approach was used in the control group while transmasseteric antroparotid approach was used in
the study group. Patients were carefully followed up 6 months.
Results: There was significant difference between the two groups regarding the incision time (P-value 0.001) however there
was no significant difference between the two groups regarding the total intra-operative time (P-value 0.123) .Immediate
postoperative facial nerve affection was higher in the transparotid approach group (30%) however 6 months postoperative total
recovery occurred and both groups showed no statistically significant difference. The transparotid approach group showed more
patient satisfaction toward the scar with mean scale 4.2 ± 0.6 versus 3.9 ± 0.6 for transmasseteric approach group however there
was no statistically significant difference between the two groups. 90% of patients in transmasseteric approach group showed
reduction to the normal anatomical position versus 70% in the transparotid group but there was no statistically significant
difference between both groups. Comparable results showed between the two groups regarding the TMJ function with no
statistically significant difference.
Conclusion: The transmasseteric antroparotid approach showed to be a useful alternative to the transparotid approach in
treating condylar neck fractures with very good accessibility and low complication rate.