[Extraoral and intraoral endoscopically assisted management of collum fractures].

AIM OF THE STUDY: Using limited extraoral and transoral incisions for an endoscopically assisted open reduction of condylar mandible fractures, the risk of facial nerve damage and extensive visible scars can be reduced. PATIENTS AND METHODS: The endoscopically assisted treatment of 17 consecutive patients with fractures of the condyle was performed from April 1998 to December 1999. Of the 17 patients, 14 had additional mandibular fractures, and 11 of the condylar fractures were dislocated. Of the 17 patients, 9 were treated by submandibular and 8 by transoral approach. Adequate anatomic reduction was achieved by the submandibular and transoral approaches using an endoscopically assisted technique. APPROACHES: In four patients angulated drills and screwdrivers facilitated the transoral treatment of condylar fractures. Transbuccal stab incisions and the use of trocars were not needed in these four patients. The transoral approach proved to be a reliable surgical approach for fractures of the mandibular condyle even when dislocation with lateral override was present. The extraoral approach was used for severely dislocated fractures such as fractures with medial override or comminution.