Akademik Veri Yönetim Sistemi
AÇBİD 15th İnternational Congress, Antalya, Türkiye, 11 - 15 Mayıs 2022, ss.69-70
Objective: Recommended approaches for accessing the condylar and pericondylar regions include, preauricular, postauricular, endoscopic, endaural, retromandibular and submandibular approaches. In this study, the removal of the metallic part in the mandibular subcondylar region as a result of a gunshot injury using the retromandibular transparotid approach will be explained.
Case: A-46-year-old patient applied to our clinic with the complaint of pain in the subcondylar region of the mandible.In the patient’s anamnesis, it was learned that he had a gunshot wound to the mandible years ago.As a result of the clinical and radiographic examination of the patient, a radiopaque foreign substance was detected in the relevant region. It was decided to remove the object in the region with the retromandibular transparotid approach. The patient was planned to remove the object under general anesthesia. After passing the cutaneous, subcutaneous and parotid capsule, Facial nerve branches were identified with a nerve stimulator and blunt dissection was performed with a curved hemostat on both sides of the nerve pathway to access the masseter muscle. The area related with the subperiosteal dissection was reached using the periosteum elevator. Metallic substance was removed.The parotid capsule and subcutaneous tissues are absorbable, skin tissue monofilament non-absorbable closed with sutures.
Conclusion: The retromandibular transparotid approach has significant advantages in accessing the subcondylar and ramus regions. Complications of the retromandibular transparotid approach include salivary gland fistula, Frey’s syndrome, limitation and pain in temporomandibular (TMJ) movements, hypoesthesia in the ear, and facial nerve damage. These complications did not occur in our patient. The follow-up of the patient continues.
Keywords: Retromandibular transparotid approach, Trauma