Review of Endoscopic Repair of Mandible Fractures

Introduction: Fractures of the mandibular condyle represent more than 30% of all mandible fractures. If required, reduction has been performed using either a closed or an open technique with similar outcomes. Endoscopic fracture repair is a minimally invasive approach for open reduction, but there is limited data regarding indications and outcomes. This study aims to systematically review the demographics, features, and outcomes following endoscopic repair of mandibular fractures in adult patients. Methods: The following databases were searched from their inception to December 31, 2016: PubMed, Cochrane, Web of Science, and the WHO Global Health Library, using terms related to endoscopy and mandibular fractures. Articles were screened and data were extracted by 2 independent reviewers. Disagreements arbitrated by discussion or a 3rd reviewer. Results: Twenty-two manuscripts were included, representing 509 adult patients who had endoscopic repair of a mandibular fracture over 18 years. All endoscopic repairs were of the mandibular condyle, including both subcondylar and condylar neck fractures. The sample-sized weighted mean age was 33.5 years with 74.5% males in the study population. Permanent facial nerve injury was reported once (0.24%) and occlusive complications reported in 31 patients (6.5%). Conclusion: This systematic review identifies a large cohort of patients who underwent endoscopic repair of their mandibular fractures. Complications were rare and usually temporary, with permanent complications occurring at a respectable rate. The demographics and outcomes identified in this study can be used as an epidemiologic baseline for future research on endoscopic repair of mandibular fractures.