Sugawara Yasushi, Hirabayashi Shin-Ichi, Susami Takafumi, Hiyama Shigetoshi
Department of Plastic and Reconstructive Surgery, Jichi Medical School, Tochigi, Japan.
Cleft Palate Craniofac J. 2002 Nov;39(6):646-54. doi: 10.1597/1545-1569_2002_039_0646_ttohhp_2.0.co_2.
To present a case of hemimandibular hyperplasia (HH) treated with orthognathic surgery that preserves the condyle without disturbing mandibular function.
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.
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.
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.
介绍一例采用正颌手术治疗半侧下颌骨增生（HH）的病例，该手术保留髁突且不干扰下颌功能。
一名患有HH的27岁女性接受了保留增大髁突头部的正颌手术。影像学检查显示右侧髁突典型增大、右侧升支和下颌体伸长以及咬合平面倾斜。在未受影响侧进行下颌矢状劈开截骨术，在受影响侧进行髁突下升支截骨术，进行Le Fort I楔形截骨术以重新调整倾斜的咬合平面，并对下颌下缘进行塑形。
在全面部外观和咬合方面取得了优异的效果。术后4年保留的髁突头部大小没有变化。在一系列使用肌电图、下颌运动造影和计算机辅助诊断轴面断层摄影术对颌功能进行的检查中，术后获得了更有利的结果。
在生长活动未异常旺盛的HH病例中，保留肥大髁突的正颌手术除了能带来良好的咬合和美学效果外，还能改善功能。
