Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion Institution of Technology.
J Craniofac Surg. 2020 Sep;31(6):1727-1730. doi: 10.1097/SCS.0000000000006480.
Endoscopically assisted open reduction and internal fixation has cumulate advantages over both open and closed techniques. Even though, this approach had not become popular. The study intended to summarize the outcomes and complications from the first 12 consecutive cases of sub condylar fractures that treated by endoscope and trans-buccal trocar. All patients experienced improvement in mouth opening. No postoperative malocclusion was noticed. The learning curve was assessed subjectively regarding the use of the endoscope and objectively by operating time reduction. The significant decrease in operating time and the ease of handling the endoscope were already noticed after the 5th operation. The mean time for endoscopically assisted open reduction and internal fixation in our study was 180 minutes, which was the same as for external approaches open reduction and internal fixation for sub-condylar fracture cases. No special designed instruments except an endoscope and a trans-buccal trocar were used. We can conclude that the learning curve for this technique is not as steep as it was thought to be, and it can be mastered after a relatively small number of operations. There is no difference in mean operation time comparing to external approaches. No need for special designed instruments.
经内镜辅助下切开复位内固定术在开放性和闭合性技术方面都有优势。尽管如此，这种方法并没有普及。本研究旨在总结 12 例连续经内镜辅助经颊套管治疗下颌骨髁突骨折的结果和并发症。所有患者的张口度均有改善，无术后错颌。使用内镜的学习曲线是主观评估的，手术时间的减少是客观评估的。第 5 次手术后，已经明显注意到手术时间的显著减少和内镜的易于操作。我们研究中经内镜辅助切开复位内固定的平均时间为 180 分钟，与经外部入路切开复位内固定治疗下颌骨髁突骨折的时间相同。除了内镜和经颊套管外，没有使用特殊设计的器械。我们可以得出结论，这种技术的学习曲线并不像想象的那么陡峭，经过相对较少的操作就可以掌握。与外部入路相比，平均手术时间没有差异。不需要特殊设计的器械。
