Is a deep subfascial approach better than the subfascial apporach to temporo-mandibular joint in terms of facial nerve injury and quality of life?

PURPOSE: The objective of the study was to compare the deep subfascial approach to subfascial approach in terms of facial nerve injury and quality of life.

MATERIALS AND METHODS: A randomized study was performed from August 2013 to March 2017 on 24 patients with unilateral TMJ ankylosis. The subjects were randomly allotted to either Group I (12, Deep Subfascial) or Group II (12, Subfascial). All patients were evaluated objectively for facial nerve injury post-operatively and subjectively for quality of life in the form of a questionnaire post-operatively for 6 months. The data were analyzed using simple descriptive statistics, mean standard deviation, Wilcoxon paired t test, Friedman's test, and Mann Whitney U test.

RESULTS: The comparison of the difference between the groups for postoperative facial nerve function at various time intervals did not give any significant differences (p > 0.05). In terms of quality of life there was a significant difference at 1 month post-operatively (p < 0.05) amidst the two approaches, however, 6-month follow-up revealed that there is no significant difference between the two approaches (p > 0.05).

CONCLUSION: The study reveals that both the approaches are safe in terms of facial nerve injury and quality of life long term.