Endoscopic approach to the ramus/condyle unit: Clinical applications

Purpose: The purpose of this report is to describe use of an endoscopic tec hnique for exposure of the mandibular ramus/condyle unit (RCU) to facilitat e reconstructive jan: procedures. Patients and Methods: This is a retrospective evaluation of 10 patients wit h diagnoses of idiopathic condylar resorption (n = 2), subcondylar fracture (n = 5), mandibular prognathism (n = 1), condylar hyperplasia (n = 1), and mandibular asymmetry (n = 1), who underwent endoscopic exposure of the RCU . Results: All 10 patients had successful reconstruction of the RCU using the endoscopic approach. The procedures performed included the following: cond ylectomy (n = 5 sides), costochondral graft reconstruction (n = 4 sides), r eduction of subcondylar fracture (n = 5 sides), and mandibular ramus osteot omy (n = 4 sides), Mean operating time was 84 minutes. No patients had marg inal mandibular nerve weakness or other complications. Conclusion: This case series demonstrates the feasibility of endoscopic acc ess to the RCU. The procedures can be performed with no increase in operati ve time and with minimal morbidity. (C) 2001 American Association of Oral a nd Maxillofacial Surgeons.