Chen Min-jie, Yang Chi, Qiu Ya-ting, Zhou Qin, Huang Dong, Shi Hui-min
From the Departments of *Oral and Maxillofacial Surgery, and †Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
J Craniofac Surg. 2014 Sep;25(5):1703-6. doi: 10.1097/SCS.0000000000000898.
The objectives of this study were to introduce the classification of osteochondroma of the mandibular condyle based on computed tomographic images and to present our treatment experiences.
From January 2002 and December 2012, a total of 61 patients with condylar osteochondroma were treated in our division. Both clinical and radiologic aspects were reviewed. The average follow-up period was 24.3 months with a range of 6 to 120 months.
Two types of condylar osteochondroma were presented: type 1 (protruding expansion) in 50 patients (82.0%) and type 2 (globular expansion) in 11 patients (18.0%). Type 1 condylar osteochondroma presented 5 forms: anterior/anteromedial (58%), posterior/posteromedial (6%), medial (16%), lateral (6%), and gigantic (14%). Local resection was performed on patients with type 1 condylar osteochondroma. Subtotal condylectomy/total condylectomy using costochondral graft reconstruction with/without orthognathic surgeries was performed on patients with type 2 condylar osteochondroma. During the follow-up period, tumor reformation, condyle absorption, and new deformity were not detected. The patients almost reattained facial symmetry.
Preoperative classification based on computed tomographic images will help surgeons to choose the suitable surgical procedure to treat the condylar osteochondroma.
本研究的目的是介绍基于计算机断层扫描图像的下颌骨髁突骨软骨瘤的分类，并分享我们的治疗经验。
2002年1月至2012年12月，我科共治疗61例髁突骨软骨瘤患者。对临床和放射学方面进行了回顾。平均随访期为24.3个月，范围为6至120个月。
呈现两种类型的髁突骨软骨瘤：1型（突出性膨胀）50例（82.0%），2型（球形膨胀）11例（18.0%）。1型髁突骨软骨瘤呈现5种形态：前/前内侧（58%）、后/后内侧（6%）、内侧（16%）、外侧（6%）和巨大型（14%）。对1型髁突骨软骨瘤患者行局部切除术。对2型髁突骨软骨瘤患者行半髁突切除术/全髁突切除术，采用肋软骨移植重建，有或无正颌手术。随访期间，未发现肿瘤复发、髁突吸收和新的畸形。患者几乎恢复了面部对称性。
基于计算机断层扫描图像的术前分类将有助于外科医生选择合适的手术方法来治疗髁突骨软骨瘤。
