title: Analysis of complications following endoscopically assisted treatment of mandibular condylar fractures.
abstract: BACKGROUND
  Within the field of facial reconstructive surgery, minimally invasive procedures are used for the treatment of temporomandibular joint disorders, traumas, and salivary glands and base of skull tumors. The recent report of endoscopic approach for treating subcondylar fractures of the mandible is designed to provide a new method for the treatment of subcondylar fractures using an endoscope through a limited transoral incision. To the best of our knowledge, the advantages and the disadvantages of an endoscopically assisted approach to mandibular condylar fracture have not been verified in studies with a high level of evidence. The objective of this article was to present our experience regarding the endoscopically assisted reduction of subcondylar mandibular fractures with a special focus on complications.
  
  
  METHODS
  The records of 14 patients who underwent surgical repair of subcondylar fractures by transoral endoscopic-assisted technique from January 2005 to December 2008 at the Maxillofacial Surgery Unit of Novara Major Hospital were reviewed retrospectively. The measures for the surgical objectives included the following outcome variables: (1) operation time, (2) cosmetic outcome, (3) salivary fistulas, (4) infection, (5) delayed wound healing, (6) facial nerve damage, (7) hemorrhage, (8) repeat interventions, (9) bone consolidation, (10) occlusion changes, and (11) temporomandibular joint dysfunction.
  
  
  RESULTS
  Our data show that we have had 4 complications (28%) experienced by 4 different patients: (1) arterial hemorrhage, (2) facial nerve injury, (3) nonunion, and (4) partial condylar reabsorption.
  
  
  CONCLUSIONS
  Although we cannot draw statistically significant conclusions, we think that further randomized clinical trials should be necessary to analyze this method; we believe that there is not an ideal approach for a fracture, but each patient needs to be fully evaluated carefully preoperatively, and the more convenient approach needs to be selected for each case.
authors.affiliation: Department of Maxillo-Facial Surgery Azienda Ospedaliera Maggiore della Carità University of Piemonte Orientale Amedeo Avogadro, Novara, Italy. fraarcuri@libero.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Arcuri
authors.forename: Matteo
authors.initials: M
authors.lastname: Brucoli
authors.forename: Nicola
authors.initials: N
authors.lastname: Baragiotta
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Benech
authors.forename: Sonia
authors.initials: S
authors.lastname: Ferrero
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Benech
mesh_terms: D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D004954:Esthetics; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries* / Q000601:surgery*; D008337:Mandibular Fractures / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome