Abstract: Objective: To evaluate the efficacy of transmasseteric anterior parotid approach for open reduction of mandibular subcondylar fractures. Methods: From July 2014 to July 2016, 18 cases with mandibular subcondylar fractures were recruited in this study. The skin flap with the subcutaneous layer was elevated anteriorly in the plane superficial to the platysma muscle and the parotid fascia, and then the fracture was exposed by blunt dissection of the masseter between the upper and lower buccal branches of the facial nerve after revealing the surface of the masseter muscle through the anterior border of the parotid gland. Finally, the fracture was reducted using single L-shaped titanium plate. Moreover, before all surgeries, temporomandibular joint and parotid region were studied at five Chinese adult cadavers fixed by 10％ formalin. Results: All 18 patients achieved satisfactory occlusion and mouth opening, no postoperative facial paralysis occurred in all cases. Conclusion: It is crucial to know well the anatomy of both the temporomandibular joint and the parotid region to reduce the surgical trauma and complications. Transmasseteric anterior parotid approach is a feasible approach in the surgical treatment for the mandibular subcondylar fractures because it can provide adequate exposure and minimal facial nerve injury, achieve reduction easily, and avoid conspicuous scar.

Key words: Mandibular subcondylar fracture, Transmasseteric anterior parotid approach, Clinical anatomy