Background and objectives: The main goal of the study was evaluation of efficiency and benefits of endoscopically assisted intraoral approach in treatment of patients with mandibular condylar fractures. All patients received computer tomography (CT) and conventional X-ray in preoperative and postoperative period besides the routine clinical diagnostics. We also evaluated intraoperative features and neurological disorders in case of conventional extraoral submandibular or periangular approach in comparison with intraoral approach.
Methods: We have performed examination and treatment of 19 patients with mandibular condylar fracture using endoscopically assisted intraoral approach. We compared clinical data and treatment results with the group of 14 patients treated using conventional submandibular or periangular approach. All of 33 patients had unilateral condylar fracture, in some cases it was bilateral body and condylar fracture. Neurological status was evaluated clinically. Osteosynthesis efficiency was evaluated using CT and conventional X-rays.
Results: As a result of our study we noted no difference in reduction or osteosynthesis quality in case of both approaches. Average operation time in case of intraoral approach was extended for 50 min. In case of intraoral approach we observed only 2 neurological disorders while in 9 cases of 14 in conventional approach we revealed temporary facial nerve palsy. No extraoral scars in case of intraoral approach. Only 1 intraoral surgery was finished extraorally.
Conclusions: As result of our study we revealed that endoscopically assisted intraoral approach for condylar fracture osteosynthesis is minimally invasive procedure. Main benefits for intraoral approach in comparison with conventional are significantly lower risk of neurological disorders and no scarification. From the other hand endoscopically assisted intraoral approach requires expensive tools and extends intraoperation time.
Key words : condylar fracture; osteosynthesis; intraoral approach