Feasibility of Endoscopic Intramedullary Fixation of Fractures of the Mandibular Condyle

Abstract

Objective: 1) Describe a novel technique for internal fixation of mandibular condyle fractures, as well as a new type of implant for the same. 2) Demonstrate surgical feasibility of this technique in a cadaver model.

Method: A transoral endoscopic approach was used to access the osteotomized mandibular condyle in 2 human cadavers. Titanium intramedullary implants were placed endoscopically after reaming of the medullary space without the need for transbuccal puncture or facial incisions.

Results: Both cadaveric mandibular condyles were successfully repaired with rigid intramedullary internal fixation without the use of external incisions. Both insertion of a peg type implant and screwing a threaded implant into the condylar head are possible. The inferior portion of the implant remains exposed and the ramus of the mandible can be manipulated into position on the implant using retraction at the sigmoid notch.

Conclusion: True total endoscopic repair of fractures of the mandibular condyle is possible by utilizing novel intramedullary titanium implants and a transoral endoscopic approach. This is the first description of the technique and implants for endoscopic intramedullary fixation of fractures of the mandibular condyle.