Postauricular Approach for Mandibular Angle Ostectomy: An Alternative for Shortening the Recovery Time.

ABSTRACT

Many surgical procedures to improve mandibular contour have been introduced in East Asia. Despite consensus regarding mandible contouring surgery, surgery which includes angle ostectomy and lateral cortex excision, some patients require only mandibular angle ostectomy. The intraoral approach is a widely used method, but has disadvantages with regard to the need for endotracheal intubation and patients are limited in their food intake for a considerable length of time. The authors wanted to shorten the recovery period and so the postauricular approach is introduced in this study and assessed.One hundred seventy-five Asian patients underwent mandibular angle ostectomy via a postauricular approach. All operations were performed under intravenous sedation without endotracheal intubation. Superficial subcutaneous dissection and vertical dissection were performed, with special care taken to avoid injuring the facial nerve. Patients responded to a simple questionnaire during the postoperative period. Questions solicited the patient's reason for their choice of this approach and their satisfaction with it.No visible scar and no palpable bony step were observed without ear pulling. Some patients experienced temporary sensory changes in the postauricular area. None of the patients complained of perioral numbness or facial paralysis. Six patients had significant bleeding in the operative field and 1 patient experienced salivary leakage for 2 weeks which was managed well without event. Of the 175 patients, 133 responded to the questionnaire. Satisfaction was expressed by 94.7% of patients and 88.7% of patients would recommend this surgery to their friends; 69.2% of patients experienced inconvenience for 1 week or less.The postauricular approach for mandibular angle ostectomy is a very convenient method for surgeons to use for patients who want to undergo mandibular angle ostectomy with a short recovery time.