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Active Unilateral Condylar Hyperplasia Treated With Simultaneous Condylectomy and Orthognathic Surgery: A Clinical
Timothy A Turvey1, Elisa Hannan2, Thomas Brader2
1Professor of Oral and Maxillofacial Surgery, UNC Adams School of Dentistry Division of Craniofacial and Surgical Services, UNC Adams School of Dentistry, Chapel Hill, North Carolina.
Purpose:
To review and report the demographic and diagnostic data in a population with active unilateral condylar hyperplasia. The surgical intervention, sequencing of surgery, and treatment outcomes, including a quality-of-life survey, are described.
Materials And Methods:
Eighty patients were diagnosed with active disease. Demographic, treatment, and treatment outcomes were assessed. Quality of life was assessed by a 21-question questionnaire.
Results:
Women were affected more frequently than men (W - 52; 65%; P = .008). Hemimandibular elongation (HE) (49; 61%; P - .004) occurred more frequently than hemimandibular hyperplasia (HH) (24; 30%) and HH-HE (7; 9%). Right side was affected more than left (R - 49; 61%; P - .003) overall, and when stratified. All racial groups were represented. Of the 80 patients in the sample, 80 (100%) underwent condylectomy on the side of active growth, 70 (87%) underwent bimaxillary osteotomies, 53 patients (66%) had single-piece maxillary osteotomies, 17 (21%) underwent segmental maxillary osteotomies, and 38 (48%) genioplasties were performed. Four patients (5%) underwent a second operation within a year of the first surgery to adjust the position of the mandible. Four (5%) facial nerve deficits were recorded. Class I cuspid occlusion was achieved with coincident maxillary and mandibular midlines and resolution of crossbite in 70 (88%) patients. Twenty three of the 24 respondents (96%) reported that they were satisfied with the treatment.
Conclusions:
Both HH and HE are diagnosed through clinical and radiographic examinations. Our results showed that HE occurs more frequently, all deformity subclassifications occur more frequently in females, the majority present in adolescence, and all racial groups are affected. The right side predominated. This study suggests that simultaneous condylectomy and orthognathic surgery provides predictable and stable outcomes for patients with active unilateral condylar hyperplasia and associated dentofacial deformities with an improvement in quality of living.
