title: Endoscopic mandibular osteotomy, and placement and activation of a semiburied distractor.
abstract: OBJECTIVE
  The purpose of this study was to demonstrate the feasibility of endoscopic placement and activation of a semiburied distraction device in the porcine mandible.
  
  
  METHODS
  Sixteen cadaver and two live anesthetized minipigs were used in this study. Access to the mandible was gained through two 1.0-cm submandibular incisions used for a working port and a visualization port. Under endoscopic visualization, dissection was carried sharply to the mandible and completed in the subperiosteal plane. Landmarks were identified through the endoscope, and a mandibular angle osteotomy was created. A semiburied distractor was then implanted, fixed to the mandible, and activated to create a bone gap. Finally, the site was explored through a submandibular incision to verify the accuracy of the endoscopic procedure.
  
  
  RESULTS
  Endoscopic exposure; accurate identification of landmarks; creation of an osteotomy; and placement, fixation, and activation of a semiburied distractor were achieved in all 18 specimens. The inferior alveolar nerve was identified as the bone gap was expanded.
  
  
  CONCLUSIONS
  The results of this study indicate that the endoscopic approach described here allows exposure and osteotomy of the mandible, and placement, fixation, and activation of a distractor. In the future, this technique will be used with totally buried, miniature distraction devices.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Troulis
authors.forename: D H
authors.initials: DH
authors.lastname: Perrott
authors.forename: L B
authors.initials: LB
authors.lastname: Kaban
mesh_terms: D000818:Animals; D004724:Endoscopy; D005240:Feasibility Studies; D008334:Mandible / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D013552:Swine; D013556:Swine, Miniature