Navigator system guided endoscopic intraoral approach for remodelling of mandibular condyle in Garré syndrome.

In recent years, surgical trends showed an interest for minimally invasive surgery. Endoscopically assisted techniques were developed and widely reported. Endoscopic approaches can sometimes represent an alternative to traditional surgery. Such approaches minimize unwanted sequelae such unaesthetic scars and iatrogenic damage of facial nerve. In the reported case, the endoscopic approach and the navigator guide allowed reshaping of mandibular ramus up to the medial condilar surface, where an osteophite was present. To solve the intraarticular, mechanical obstacle, medial surface of mandibular condyle was reshaped. Such surgery represents a valid conservative solution; for traditional surgery with transcutaneous approach, a condylectomy should have been planned. The navigator (Brain Lab, Feldkirchen, Germany) allowed the checking of anatomic landmarks, even in bone with anatomy subversion, and guided its reshaping. The technique is summarized with step-by-step explanations. Further studies are obviously required to standardize the technique, and even technical and technological advances are expected, but computer-aided endoscopic surgery could be introduced to allow surgery on temporomandibular joints.