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The treatment of hemimandibular hyperplasia preserving enlarged condylar head
Yasushi Sugawara1, Shin-Ichi Hirabayashi, Takafumi Susami
1Department of Plastic and Reconstructive Surgery, Jichi Medical School, Tochigi, Japan. sugawara@jichi.ac.jp
Objective:
To present a case of hemimandibular hyperplasia (HH) treated with orthognathic surgery that preserves the condyle without disturbing mandibular function.
Methods:
A 27-year-old woman with HH was treated with orthognathic surgery preserving the enlarged condylar head. Radiographic examination showed typical enlargement of the right condyle, elongation of the right ascending ramus and mandibular body, and tilted occlusal plane. A mandibular sagittal split osteotomy on the unaffected side and subcondylar ramus osteotomy on the affected side, Le Fort I wedge osteotomy to relevel the tilted occlusal plane, and contouring of the lower mandibular margin were performed.
Results:
Excellent results in the full-face appearance and occlusion were obtained. There was no change in the size of the reserved condylar head 4 years postoperatively. In a series of examinations of jaw function with electromyography, mandibular kinesiography, and computer-aided diagnostic axiography, more favorable findings were obtained postoperatively.
Conclusions:
In a case of HH without abnormally high growth activity, orthognathic surgery preserving hypertrophic condyle produced functional improvement in addition to good occlusal and aesthetic outcomes.
