Four hands technique in transoral endoscope-assisted fixation of condyle fractures.

OBJECTIVE: We present the short-term treatment results of a modified technique in transoral endoscopic condyle repair.

DESIGN: A pilot prospective study from April 2006 to November 2007.

SETTING: Ankara University Medical School Teaching Hospital.

METHODS: Four patients with subcondylar fracture were treated with transoral endoscopic condyle repair. Preliminary restoration of the occlusion was provided with maxillomandibular fixation. Four hands endoscopic sinus surgery principles were adapted to transoral endoscopic condyle repair.

MAIN OUTCOME MEASURES: Providing condylar stabilization with good occlusion and temporomandibular joint function was expected from treatment.

RESULTS: Open reduction and internal fixation were achieved in all patients. Condylar stabilization was confirmed by intraoperative endoscopic findings and postoperative panoramic radiographs. Uneventful healing with good occlusion and temporomandibular joint function were noted in 3 to 14 months of follow-up.

CONCLUSION: Endoscope-assisted minimal invasive procedures have been taking more part in head and neck soft tissue and trauma surgery. The cost of instruments and technical difficulties are the main constraints of endoscopic techniques. In this study, we present a practical way to perform transoral endoscopic condyle repair using the otolaryngologist's standard sinus surgery endovisual equipment and a titanium miniplate system. With the addition of a surgical hand, successful treatment results could be achieved with reduced cost.