Condylar hyperplasia: correlation between clinical, radiological, scintigraphic, and histologic features.

PURPOSE

The objectives of this study were to compare demographic, clinical, radiographic, scintigraphic, and histologic differences between the 2 main types of condylar hyperplasia (CH) and to suggest a new therapeutic management based on such findings.

METHODS

This was a retrospective study based on 28 patients who presented either vertical (group 1) or horizontal (group 2) forms of CH and underwent surgical treatment. Every patient had a complete preoperative clinical and radiological examination as well as a single-photon emission computed tomography scan. A histologic analysis of each resected condyle was performed. These various parameters were then compared in the 2 patient groups.

RESULTS

The mean age at time of the diagnosis was 25.8 years (range, 12-50 years), and there were 22 females and 6 males. Nineteen patients had the vertical form of CH, and 9 had the horizontal form. Scintigraphic analysis showed moderate to extensive radionucleotide uptake in cases with rapid growth. Four cases had negative single-photon emission computed tomography scan uptake, and all were vertical forms, but there was no statistically significant difference between the 2 groups. The histologic analysis showed both a global thickening of the cartilage cap and of the prechondroblastic cells layer with no statistically significant difference between the 2 groups.

CONCLUSIONS

Condylar hyperplasia is a pathologic condition affecting mainly young females and whose origin remains unknown. Single-photon emission computed tomography scans as an indicator of the rapidity of the disease progress are essential in assessing the condylar hyperplasia and to guide the therapeutic approach.