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.

Background: Temporomandibular joint (TMJ) ankylosis is an uncommon condition in the modern world, yet it remains a significant treatment challenge. One of the main intraoperative difficulties is accurately and safely resecting the ankylotic mass. Objective: This study seeks to share our clinical experience with various types of complications and to review the literature on the clinical and technological evidence regarding the accuracy of surgical detachment of the ankylotic mass from the skull. Methods: A literature review was conducted using PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Search strategies were categorized into search 1 for evaluating 3D-printed technology and search 2 for computer-assisted surgical navigation. Results: One study was selected for search 1 and 2 for search 2. Also, three cases of intraoperative surgical complications associated with the resection of the ankylotic mass were presented. The 3D surgical cutting guides were found to be accurate in guiding the superior, inferior, and depth of the osteotomy. Angulation control was less than optimal. Navigation guiding proved accurate in maintaining the planned thickness of the skull base and the anterior wall of the external auditory canal. Conclusion: Navigation guiding is a superior method for achieving predictable anatomical resection of the ankylotic mass.