Advancing precision in bilateral sagittal split osteotomy: a pioneering perspective on minimizing inferior alveolar nerve injury through endoscopic visualization.

BACKGROUND: Minimal invasive surgical procedures are popularized in various surgical fields, the utilization of endoscopic assisted techniques continues to grow across in the field of Maxillofacial Surgery. Orthognathic surgery is a commonly employed procedure for skeletal deformities. Bilateral sagittal split osteotomy(BSSO) is a versatile, result oriented procedure and its utility are well documented. The main pitfall is injury to the neurovascular bundle. Although various methods and modified instrumentation are advocated to minimize the injury to IAN.

PURPOSE: The primary objective is to study the efficacy of innovative endoscopic assisted procedure for locating the nerve and preventing its injury during the BSSO.

MATERIAL AND METHODOLOGY: This initial prospective study involving 10 patients undergoing BSSO ( advancement / setback) has explored the role of endoscopic assisted to precisely identify and safeguard the nerve during osteotomy cuts, identification and releasing of IAN while splitting the proximal and distal fragments of BSSO.

RESULTS AND CONCLUSION: Integration of the endoscopy in BSSO protocols showed more than 50% reduction in injury to Neurovascular bundle and offers a promising advancement for achieving favourable results.