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Endoscopic vertical ramus osteotomy: a long-term prospective study.

M E Papadaki1, L B Kaban1, M J Troulis1

  • 1The Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA.

International Journal of Oral and Maxillofacial Surgery
|November 20, 2013
PubMed
Summary

Endoscopic vertical ramus osteotomy (EVRO) offers a fast and stable surgical solution for mandibular prognathism and asymmetry, with minimal complications and quick recovery. Most patients achieved excellent skeletal stability post-procedure.

Keywords:
endoscopic vertical ramus osteotomymandibular prognathismrigid fixation

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Orthognathic Surgery
  • Minimally Invasive Surgical Techniques

Background:

  • Mandibular prognathism and asymmetry present significant functional and aesthetic challenges.
  • Traditional surgical correction methods can involve extensive procedures and longer recovery times.
  • Endoscopic techniques offer potential advantages in reducing surgical invasiveness.

Purpose of the Study:

  • To prospectively evaluate the clinical outcomes of endoscopic vertical ramus osteotomy (EVRO) with rigid fixation.
  • To assess the efficacy and stability of EVRO in treating mandibular prognathism and asymmetry.
  • To document complications and recovery parameters associated with EVRO.

Main Methods:

  • Prospective evaluation of patients undergoing EVRO with rigid fixation.
  • Inclusion criteria: age >15 years, adequate documentation, and ≥3-year follow-up.
  • Data collected: demographics, pre-operative, immediate post-operative, and latest follow-up cephalometrics, procedure details, complications, and hospital stay.

Main Results:

  • Seventeen EVROs performed on 10 patients with mandibular hyperplasia, condylar hyperplasia, or asymmetry.
  • Mean operative time: 33 minutes per side; mean mandibular setback: 4.7 mm; mean hospital stay: 1.9 days.
  • Skeletal stability achieved in 90% of patients; transient inferior alveolar nerve paresthesia in 4 patients, resolving postoperatively. No facial nerve deficits.

Conclusions:

  • Endoscopic vertical ramus osteotomy (EVRO) is a rapid procedure with minimal blood loss and a quick recovery.
  • EVRO demonstrates favorable skeletal stability for treating mandibular prognathism and asymmetry.
  • The technique presents a safe and effective alternative with a low complication rate.