Endoscopic approach to the ramus/condyle unit: Clinical applications

Area of Science:

• Oral and Maxillofacial Surgery
• Minimally Invasive Surgical Techniques
• Reconstructive Jaw Surgery

Background:

• Reconstruction of the mandibular ramus/condyle unit (RCU) is crucial for various jaw pathologies.
• Traditional open approaches for RCU access can involve significant morbidity.
• Development of minimally invasive techniques is essential for improving patient outcomes.

Purpose of the Study:

• To describe the utility of an endoscopic technique for RCU exposure.
• To evaluate the feasibility of this approach in facilitating reconstructive jaw procedures.

Main Methods:

• Retrospective review of 10 patients undergoing endoscopic RCU exposure.
• Patients presented with diagnoses including idiopathic condylar resorption, subcondylar fracture, prognathism, hyperplasia, and asymmetry.
• Procedures included condylectomy, graft reconstruction, fracture reduction, and ramus osteotomy.

Main Results:

• Successful RCU reconstruction was achieved in all 10 patients via the endoscopic approach.
• Procedures performed: condylectomy (5), costochondral graft reconstruction (4), subcondylar fracture reduction (5), ramus osteotomy (4).
• Mean operative time was 84 minutes, with no reported marginal mandibular nerve weakness or other complications.

Conclusions:

• Endoscopic access to the RCU is feasible for reconstructive jaw surgery.
• The technique allows for complex procedures without increasing operative time.
• This approach offers a minimally morbid alternative for RCU reconstruction.