A 21-year-old male patient presented with a bilateral condylar and a symphysis fracture. In this case, a combined approach was employed to reduce and fix the fractured condyle. The right medially displaced condylar fracture was addressed. A preauricular approach was advocated to retrieve the medially displaced fractured condyle []. To facilitate proper reduction and fixation of the fractured segments, a retromandibular approach was also used. We used Hegar's uterine dilators in sequence to create an accessible working space for reduction and fixation, passing it through the retromandibular incision, and exiting through the preauricular incision []. During plating, the superior screws were placed through the preauricular incision and the inferior screws were placed through the retromandibular incision. Finally, the symphysis fracture was reduced and fixed through an intraoral vestibular incision. Postoperative radiograph was taken to assess the surgical outcome [].
A 79-year-old woman visited our emergency department with three stab wounds in her right preauricular area (). We found no abnormal finding during the retrograde irrigation test for Stensen duct that was performed in the ampulla. However, facial expressions such as the area around the mouth and blinking of the eyes were unnatural, so the possibility of facial nerve injury could not be ruled out. An emergency exploration was performed under general anesthesia in the operating room. To minimize additional injuries and conduct a more reliable exploration of the injured areas, the wounds were connected to expose all the injured areas. Even though more dead space was created due to this procedure, we definitely found injuries in the parotid glands and an injury at a marginal mandible branch of the facial nerve (). After neurorrhaphy for the facial nerve injury, the wound was sutured, and a closed 100-mL Jackson-Pratt drainage tube was inserted (). The injured parotid gland area was not wide in size and the tissue was soft, so it was not repaired.\nAs postoperative management, oral administration of 10 mg nortriptyline once daily for 3 weeks was started from the day of surgery to prevent secondary complication, such as infection due to persistent salivation. During treatment with nortriptyline, the patient complained of mouth dryness, which showed that the drug had an anticholinergic action. The drainage tube was removed on the 6th day after the surgery, when 5 mL per day or less drainage was collected for 3 days in a row. Due to the possibility of partial wound dehiscence, delayed stitch out was planned, and all sutures were removed on the 10th postoperative day. Complete and unremarkable wound healing was observed, and no complications were reported 7 weeks postoperatively ().