Endoscopic vertical ramus osteotomy: early clinical results.
OBJECTIVE
The benefits of minimally invasive surgery have been well documented. The purpose of this report was to present early results in a series of patients who had endoscopic mandibular orthognathic surgery. Patients and methods This is a retrospective evaluation of 14 patients who underwent endoscopic vertical ramus osteotomy and rigid fixation for the treatment of mandibular prognathism (n = 9), malocclusion secondary to trauma (n = 3), or other pathology (n = 2). A 1.5-cm incision was made directly below the mandibular angle. The dissection was continued bluntly to the masseter muscle, which was incised using a needlepoint electrocautery. Then, with endoscopic elevators, an optical cavity was created for insertion of a Hopkins endoscope and visualization of the ramus/condyle unit. Anatomic landmarks were identified and the operation carried out with specially designed endoscopic equipment. Preoperative (T0), postoperative (T1), and follow-up (T2) clinical examinations; lateral cephalograms; and panoramic radiographs were used to evaluate the outcomes.


RESULTS
The procedures performed included: vertical ramus osteotomy (n = 13 patients, 23 sides) and condylectomy plus vertical ramus osteotomy (n = 1 patient, 1 side). Mean operating time was 37 minutes per side. One patient had temporary marginal mandibular nerve weakness. The occlusal result was as planned in all cases. Panoramic radiographs documented postoperative ramus/condyle unit position and lateral cephalograms documented mandibular position.


CONCLUSIONS
The results of this case series indicate that endoscopic vertical ramus osteotomy with rigid fixation is feasible for correction of a variety of mandibular deformities.
Troulis
Maria J
MJ
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114, USA.
Kaban
Leonard B
LB
D000293:Adolescent; D000328:Adult; D002508:Cephalometry; D004598:Electrosurgery; D019723:Endoscopes; D004724:Endoscopy; D005150:Facial Hemiatrophy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000601:surgery; D008334:Mandible / Q000601:surgery*; D008406:Masseter Muscle / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures; D010027:Osteotomy / Q000379:methods*; D011378:Prognathism / Q000601:surgery; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D016896:Treatment Outcome