Endoscope-assisted treatment of mandibular condylar fractures is an evolving surgical technique of this controversial subject. The approach is performed through an intraoral and additional submandibular incision. This study presents a technique for minimizing the length of the optional submandibular incision. Ten patients with displaced subcondylar fractures and malocclusion underwent endoscope-assisted open reduction and internal fixation (ORIF). A limited (<1 cm) submandibular incision (dissected under endoscopic guidance from within) was needed in eight patients to complement the intraoral incision and facilitate the reduction in the fractures. Satisfactory small scar could be obtained in all patients with neither wound complications nor facial nerve injuries. Our technique depends on dissection first then incision. Performing the external incision after complete intraoral dissection is safe for the facial nerve and minimizes scarring markedly. This very limited submandibular incision facilitates reduction in relatively difficult cases and enables clear visualization of posterior border of the mandible to confirm adequate fracture reduction.
SchönRFaklerOGellrichNCSchmelzeisenRFive-year experience with the transoral endoscopically assisted treatment of displaced condylar mandible fracturesPlast Reconstr Surg2005116144–50
2.
MitchellDAA multicentre audit of unilateral fractures of the mandibular condyleBr J Oral Maxillofac Surg1997354230–236
3.
SilvennoinenUIizukaTLindqvistCOikarinenKDifferent patterns of condylar fractures: an analysis of 382 patients in a 3-year periodJ Oral Maxillofac Surg199250101032–1037
4.
StaceyDHDoyleJFMountDLSnyderMCGutowskiKAManagement of mandible fracturesPlast Reconstr Surg2006117348e–60e
5.
DraaijersLJTempelmanFRBotmanYA, et al. The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluationPlast Reconstr Surg200411371960–1965, discussion 1966–1967
6.
SingerAJAroraBDagumAValentineSHollanderJEDevelopment and validation of a novel scar evaluation scalePlast Reconstr Surg200712071892–1897
7.
BoutrosSGClosed reduction and fluoroscopically assisted percutaneous stabilization of displaced subcondylar mandible fracturesPlast Reconstr Surg20051164971–977
8.
SilvermanSLNew operation for displaced fractures at the neck of the condyleInt J Orthod192567876
9.
WassmundMUber Luxations frakturen des KiefernglenkesDtsch Kieferchir.1934127
10.
HaugRHBrandtMTClosed reduction, open reduction, and endoscopic assistance: current thoughts on the management of mandibular condyle fracturesPlast Reconstr Surg200712070290S–102S
11.
LauerGSchmelzeisenREndoscope-assisted fixation of mandibular condylar process fracturesJ Oral Maxillofac Surg199957136–39, discussion 39–40
12.
LeeCStiebelMYoungDMCranial nerve VII region of the traumatized facial skeleton: optimizing fracture repair with the endoscopeJ Trauma2000483423–431, discussion 431–432
13.
SandlerNAAndreasenKHJohnsFRThe use of endoscopy in the management of subcondylar fractures of the mandible: a cadaver studyOral Surg Oral Med Oral Pathol Oral Radiol Endod1999885529–531
14.
SchönRSchmelzeisenREndoscopic fracture treatmentAnn R Australas Coll Dent Surg20021640–45
15.
MuellerREndoscopic treatment of facial fracturesFacial Plast Surg200824178–91
16.
SchmelzeisenRLauerGWichmannUEndoscope-assisted fixation of condylar fractures of the mandible [in German]Mund Kiefer Gesichtschir1998201S168–S170
17.
SchönRGutwaldRSchrammAGellrichNCSchmelzeisenREndoscopy-assisted open treatment of condylar fractures of the mandible: extraoral vs intraoral approachInt J Oral Maxillofac Surg2002313237–243
18.
KellmanRMEndoscopic approach to subcondylar mandible fracturesFacial Plast Surg2004203239–247
SandlerNAEndoscopic-assisted reduction and fixation of a mandibular subcondylar fracture: report of a caseJ Oral Maxillofac Surg200159121479–1482
22.
MiloroMEndoscopic-assisted repair of subcondylar fracturesOral Surg Oral Med Oral Pathol Oral Radiol Endod2003964387–391
23.
SchönRSchrammAGellrichNCSchmelzeisenRFollow-up of condylar fractures of the mandible in 8 patients at 18 months after transoral endoscopic-assisted open treatmentJ Oral Maxillofac Surg200361149–54
24.
TroulisMJEndoscopic open reduction and internal rigid fixation of subcondylar fracturesJ Oral Maxillofac Surg200462101269–1271
25.
VuralETreatment of adult subcondylar mandibular fractures: closed vs open vs endoscopic approachArch Otolaryngol Head Neck Surg2004130101228–1230
26.
MuellerRVCzerwinskiMLeeCKellmanRMCondylar fracture repair: use of the endoscope to advance traditional treatment philosophyFacial Plast Surg Clin North Am20061411–9
27.
AzizSRZiccardiVBEndoscopically assisted management of mandibular condylar fracturesAtlas Oral Maxillofac Surg Clin North Am200917171–74
BiglioliFCollettiGTransmasseter approach to condylar fractures by mini-retromandibular accessJ Oral Maxillofac Surg200967112418–2424
33.
BiglioliFCollettiGMini-retromandibular approach to condylar fracturesJ Craniomaxillofac Surg2008367378–383
34.
CollettiGBattistaVMAlleviFGiovandittoFRabbiosiDBiglioliFExtraoral approach to mandibular condylar fractures: our experience with 100 casesJ Craniomaxillofac Surg2014425e186–e194
35.
NicolaiGLorèBDe MarinisLCalabreseLCombined surgical approach retromandibular and intraoral to subcondylar mandibular fracturesJ Craniofac Surg20112241354–1357
36.
SchielSMayerPProbstFOttoSCorneliusCPTransoral open reduction and fixation of mandibular condylar base and neck fractures in children and young teenagers—a beneficial treatment option?J Oral Maxillofac Surg20137171220–1230
