Eur Rev Med Pharmacol Sci 2022; 26 (3): 799-809
DOI: 10.26355/eurrev_202202_27988

Risk of complications with retromandibular transparotid vs. anteroparotid approach for condylar fractures: a systematic review and meta-analysis

X.-W. Lu, X.-G. Liu

Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong Province, P.R. China. lemon-pao@sdu.edu.cn


OBJECTIVE: Retromandibular approaches have been known to reduce the risk of facial nerve palsy and improve the management of condylar fractures. As such, it is necessary to identify the best approach with the least complications. This review was conducted to obtain a comprehensive estimate for the risk of complications following both the transparotid and the anteroparotid approach for patients with mandibular condylar fractures.

MATERIALS AND METHODS: A comprehensive search was conducted using PubMed Central, EMBASE, MEDLINE, and Cochrane library, ScienceDirect and Google Scholar from January 1964 until October 2021. The Newcastle Ottawa scale and Cochrane risk of bias tool were used to assess the quality of the included studies. A meta-analysis was carried out using a random-effects model and reported pooled incidence with 95% confidence intervals (CIs). A funnel plot was used to assess possible publication biases.

RESULTS: In total, 40 studies with 2,096 participants were assessed and the majority of the included studies (29 out of 40 studies) had a high risk of bias. The pooled incidence of facial nerve palsy following the transparotid approach was 13% (95% CI: 10%-17%; I2=66.8%), and 2% (95% CI: 1%-5%; I2=57.8%) following the anteroparotid approach. The pooled incidence of sialocele following the transparotid approach was 2% (95% CI: 0%-4%; I2=45.8%), and 2% (95% CI: 1%-5%; I2=67.2%) following the anteroparotid approach. The pooled incidence of postoperative infection following the transparotid approach was 1% (95% CI: 0%-4%; I2=63.1%), and 1% (95% CI: 0%-3%; I2=0%) following the anteroparotid approach.

CONCLUSIONS: The incidence of facial nerve palsy was higher among patients undergoing the transparotid approach when compared to patients undergoing the anteroparotid approach. Further trials comparing both of these approaches are required to identify the best methodology with the lowest complication rate

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To cite this article

X.-W. Lu, X.-G. Liu
Risk of complications with retromandibular transparotid vs. anteroparotid approach for condylar fractures: a systematic review and meta-analysis

Eur Rev Med Pharmacol Sci
Year: 2022
Vol. 26 - N. 3
Pages: 799-809
DOI: 10.26355/eurrev_202202_27988