Condylectomy and “surgery first” approach: An expedited treatment for condylar hyperplasia in a patient with facial asymmetry

ABSTRACT Condylar Hyperplasia (CH) is a self-limiting pathology condition that produces severe facial deformity at the expense of mandibular asymmetry. In this case report a 15-year-old female patient was diagnosed with Unilateral Condylar Hiperplasia (UCH) by mean of single-photon emission computed tomography (SPECT) and histological study. A high condylectomy in the right condyle was performed to stop the active status of the hyperplasia. A month after condylectomy, orthognathic jaw impaction and asymmetric mandibular setback surgery was performed with the Surgery First Approach (SFA). After 10 days, orthodontic appointments were made every two weeks during 4 months. The active phase of treatment lasted 14 months. Excellent facial and occlusal outcomes were obtained and after 24 months in retention the results remained stable.

摘要：髁突增生（Condylar Hyperplasia, CH）是一类自限性病理状态，以下颌骨不对称为主要表现，可引发严重面部畸形。本病例报告中，1名15岁女性患者经单光子发射计算机断层扫描（Single-Photon Emission Computed Tomography, SPECT）及组织学检查，确诊为单侧髁突增生（Unilateral Condylar Hyperplasia, UCH）。术者为患者右侧髁突实施高位髁突切除术，以阻断增生病变的活跃进程。髁突切除术后1个月，采用手术优先方案（Surgery First Approach, SFA）开展正颌下颌截骨及不对称下颌后退手术。术后10天启动正畸治疗，每2周复诊1次，持续4个月。整个治疗活跃阶段共计14个月。最终患者获得了优良的面部外形与咬合效果，且在保持阶段随访24个月后，治疗效果仍维持稳定。