![]() Additional detractors to the popularization of endoscopic craniomaxillofacial surgery were the absence of specialized instrumentation, initially lengthy operative times and significant equipment expenses. The nasal cavity and paranasal sinuses were too small to allow for the introduction of at least two of the early instruments necessary for the principle of triangulation and unrestricted manipulation. This relatively delayed introduction was caused partly by the absence of naturally occurring cavities in the head and neck region. The decision on how to manage these specific fractures was based on individual surgeon’s experience and patient preferences.Įndoscopy was initiated to the field of craniomaxillofacial surgery by Vasconez et al who performed the first endoscopic brow lift in 1994. Others, when perceived posttraumatic deformity and dysfunction were less discernable were approached more conservatively, or simply not treated. Those fractures where the benefits of repair outweighed operative risks were treated using open reduction and internal fixation (ORIF). ![]() Nevertheless, several facial areas have remained that could not be approached without obvious surgical stigmata, most notably the mandibular condyle, zygomatic arch, the orbit, and frontal sinus. Surgical management of craniomaxillofacial trauma has undergone significant evolution over the course of the last 100 years.
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