Navigation-assisted transoral endoscopic surgery for mandibular ramus-condyle tumours

Neoplasms of the mandibular ascending ramus and condyle cause facial asymmetry, trismus, malocclusion, swelling in the temporomandibular joint area, and pain. Conventional surgeries require an external incision, with a risk of facial nerve injury and leaving a scar. This study aimed to establish a minimally invasive approach for mandibular ramus-condyle tumour resection, using intraoperative navigation and endoscopes. The safety and feasibility were assessed by cadaveric dissection. Nine patients with osteomas or osteochondromas occurring from the mandibular ascending ramus and condyle were included in this study. All patients underwent navigation-assisted transoral endoscopic resection of the tumours. Cadaveric dissection demonstrated how the transoral endoscopic approach to the mandibular ramus-condyle unit was established and enabled analysis of the anatomical structures. Mandibular tumours were successfully resected in all the patients, with a low incidence of postoperative complications, and the morphologies and functions of the mandible were satisfactorily preserved. The results indicate that navigation-assisted transoral endoscopic surgeries for the mandibular ramus-condyle tumours are feasible and effective in a preliminary clinical setting. Studies with larger sample sizes and further assessment of the navigation system are required to confirm the accuracy of the surgeries.