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Endoscopic mandibular osteotomy, and placement and activation of a semiburied distractor
M J Troulis1, D H Perrott, L B Kaban
1Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, USA.
Purpose:
The purpose of this study was to demonstrate the feasibility of endoscopic placement and activation of a semiburied distraction device in the porcine mandible.
Materials And Methods:
Sixteen cadaver and two live anesthetized minipigs were used in this study. Access to the mandible was gained through two 1.0-cm submandibular incisions used for a working port and a visualization port. Under endoscopic visualization, dissection was carried sharply to the mandible and completed in the subperiosteal plane. Landmarks were identified through the endoscope, and a mandibular angle osteotomy was created. A semiburied distractor was then implanted, fixed to the mandible, and activated to create a bone gap. Finally, the site was explored through a submandibular incision to verify the accuracy of the endoscopic procedure.
Results:
Endoscopic exposure; accurate identification of landmarks; creation of an osteotomy; and placement, fixation, and activation of a semiburied distractor were achieved in all 18 specimens. The inferior alveolar nerve was identified as the bone gap was expanded.
Conclusion:
The results of this study indicate that the endoscopic approach described here allows exposure and osteotomy of the mandible, and placement, fixation, and activation of a distractor. In the future, this technique will be used with totally buried, miniature distraction devices.