J Korean Assoc Oral Maxillofac Surg.  2015 Oct;41(5):259-264. 10.5125/jkaoms.2015.41.5.259.

Conservative condylectomy alone for the correction of mandibular asymmetry caused by osteochondroma of the mandibular condyle: a report of five cases

• Kim DS
• Kim JY
• Jeong CW
• Park KH
• Huh JK

• KMID: 2070440
• DOI: http://doi.org/10.5125/jkaoms.2015.41.5.259

Abstract

We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma.

Keyword

Osteochondroma; Condylectomy; Mandibular condyle; Facial asymmetry

MeSH Terms

Facial Asymmetry
Follow-Up Studies
Humans
Malocclusion
Mandibular Condyle*
Orthognathic Surgery
Osteochondroma*
Recurrence
Rubber
Traction
Rubber

Figure

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  Fig. 1 Posteroanterior (A-C) and panoramic radiographs (D-F) of the right condyle of patient 1 (circle, right condyle; long arrow, menton; short arrow, crossbite of left molars). A, D. Preoperative radiographs show the overgrowth of the right condyle, deviation of the menton, and crossbite. B, E. Radiographs obtained on postoperative day 1. C, F. Radiographs obtained 80 months after surgery show appropriate facial symmetry with remodeling and recovery of the contour of the remaining condylar neck. There are no signs of lesion recurrence.

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  Fig. 2 Photographs of occlusion in patient 2. A. Preoperative photographs show the occlusion in patient 2. Dental midline shift and left-sided crossbite are apparent. B. Photograph obtained on postoperative day 1. C. Photographs obtained 85 months after surgery show favorable occlusion.

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  Fig. 3 Panoramic radiographs of the right condyle in patient 2. A. Preoperative radiograph. B. Radiograph obtained on postoperative day 1. C. Radiograph obtained 85 months after surgery.

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  Fig. 4 Posteroanterior (A, B) and panoramic radiographs (C-E) of the left condyle in patient 3 (circle, left condyle; arrow, menton). A, C. Preoperative radiographs show hypertrophy of the left condyle and deviation of the menton. D. Radiograph obtained on postoperative day 1. B, E. Radiographs obtained 18 months after surgery show appropriate facial symmetry and remodeling and recovery of the contour of the remaining condylar neck.

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