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Journal of the Korean Association of Oral and Maxillofacial Surgeons

Surgery-early approach combined with condylectomy for correction of severe facial asymmetry with mandibular condylar hyperplasia: a case report

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2024, v.50 no.4, pp.227-234
https://doi.org/10.5125/jkaoms.2024.50.4.227
Hikari Suzuki (Division of Oral and Maxillofacial Reconstructive Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan)
Shinnosuke Nogami (Division of Oral and Maxillofacial Reconstructive Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan)
Yoshio Otake (Division of Oral and Maxillofacial Reconstructive Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan)
Yuri Takeda (Division of Oral and Maxillofacial Reconstructive Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan)
Junji Sugawara (Orthodontist Dr. Junji Sugawara Clinic, Sendai, Japan)
Tetsu Takahashi (Department of Oral and Maxillofacial Surgery, Southern Tohoku Fukushima Hospital, Fukushima, Japan)
Kensuke Yamauchi (Division of Oral and Maxillofacial Reconstructive Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan)

Abstract

In patients with unilateral mandibular condyle hyperplasia, whether to perform condylectomy and orthognathic surgical procedures at the same time or orthognathic surgery in two stages for remains controversial. Reported here is a case of facial asymmetry with mandibular condyle hyperplasia, for which condylectomy and orthognathic surgery procedures were performed at the same time. A 28-year-old woman was presented to our department with chief complaints of left deviation of the mandible and right temporomandibular joint (TMJ) noise. Findings obtained in several imaging examinations led to a diagnosis of facial asymmetry associated with right mandibular condyle hyperplasia. Following 3 months of preoperative orthodontic treatment, in October 2018 under general anesthesia the patient underwent a right mandibular condylectomy, Le Fort I osteotomy, right mandibular sagittal split ramus osteotomy, and left mandibular inverted L ramus osteotomy. In examinations up to 3 years after surgery, good results were noted. For this case of severe facial asymmetry with mandibular condyle hyperplasia, early surgery and condylectomy were performed simultaneously to significantly shorten the total treatment time. The effectiveness of a surgery-early approach was confirmed by no postoperative findings indicating abnormalities in the TMJ or retroversion.

keywords
Orthodontic treatment, Facial asymmetry, Orthognathic surgery

Journal of the Korean Association of Oral and Maxillofacial Surgeons