Key Concepts:

1. Custom gutting guide must sit flush against posterior and inferior borders of mandible. Check placement also from preauricular incision.
2. Depending on condyle osteotomy design, it may require 1 vs 2 condyle osteotomy.  1 osteotomy is preferred but might not be achievable depending on patient anatomy.
3. This particular patient required 2 condyle osteotomy. First osteotomy removes the condylar head to allow for the mandible to collapse towards to preauricular incision opening.  Then second osteotomy is performed using the cutting guide.
4. Coronoid process has temporalis muscle attachment that may be challenging to remove. Stay within subperiosteal tissue plane at all times to avoid injury to critical structures.
5. Remove TMJ Disc then expose articular eminence