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Endoscopically assisted sagittal split osteotomy for mandibular lengthening: technical note and initial experience.

Maurice Y Mommaerts1

  • 1Division of Maxillo-Facial Surgery, Department of Surgery, General Hospital St. Jan, Bruges, Belgium. maurice.mommaerts@azbrugge.be <maurice.mommaerts@azbrugge.be>

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|May 26, 2009
PubMed
Summary

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This study shows minimally invasive sagittal split osteotomy using endoscopy is feasible for mandibular lengthening. Patients experienced reduced swelling and a quick return to daily activities.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Minimally Invasive Surgical Techniques
  • Endoscopic Procedures

Background:

  • Sagittal split osteotomy is a common procedure for mandibular lengthening.
  • Traditional approaches can involve significant soft tissue disruption and swelling.
  • Minimally invasive techniques aim to reduce surgical trauma and improve patient recovery.

Purpose of the Study:

  • To assess the feasibility of endoscopic sagittal split osteotomy with transoral osteosynthesis.
  • To evaluate the efficacy of a minimally invasive approach for mandibular lengthening.
  • To document patient outcomes, including recovery time and complications.

Main Methods:

  • Thirty-one bilateral sagittal split osteotomies were performed using a 4-mm endoscope.

Related Experiment Videos

  • Procedures involved two distinct tunnels and one corridor for access.
  • Rigid osteosynthesis was achieved with screws, and in some cases, additional plate fixation.

    • Main Results:

    • Successful transoral osteosynthesis was achieved in most patients.
    • Minimal edema was observed, allowing a return to daily activities within one week.
    • Fixation instability occurred in four patients, managed conservatively with intermaxillary elastics.

    Conclusions:

    • Endoscopically assisted mandibular lengthening with transoral osteosynthesis is a feasible minimally invasive technique.
    • The procedure potentially reduces periosteal degloving and postoperative edema.
    • Challenges include the limited surface area for screw fixation during osteosynthesis.