Endoscopic approaches to subcondylar fractures of the mandible.

The endoscope-assisted technique for the repair of subcondylar fractures of the mandible has been in use for approximately a decade, and its acceptance continues to grow as more surgeons gain experience. It provides for transoral access to the condylar neck region of the mandible, allowing for repair of fractures in this region with minimal if any facial scarring, while also minimizing the risk of facial nerve injury. The authors describe their technique for performing the transoral, endoscopic-assisted approach for repair of subcondylar fractures and report their experience with 48 endoscopic explorations. No facial nerve injuries were encountered, and the success rate for the technique is reasonable; however, the surgeon and patient must be prepared for the possibility that an open surgical procedure may be necessary. There is a steep learning curve, and the procedure may be time consuming, particularly early on. Still, it is a reasonable technique, and it will likely remain part of the armamentarium of the craniomaxillofacial trauma surgeon.