Kim H-S, Kim J-Y, Huh J-K, Park K-H
Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea.
Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea.
Int J Oral Maxillofac Surg. 2016 May;45(5):593-600. doi: 10.1016/j.ijom.2015.12.007. Epub 2016 Jan 6.
Unilateral condylar overgrowth induces severe facial asymmetry. Therefore, treatment focuses on both elimination of the condyle lesion and correction of the facial asymmetry. The aim of this report is to present three patient cases, introducing a simpler surgical method, the indications for this surgical method, and a treatment planning flow that is consistently applicable regardless of the origin of the condylar lesion. Condylectomy was performed simultaneously with orthognathic surgery, with the vertical ramus osteotomy selected as the method of ramus surgery; ipsilateral ramus surgery was not performed on the condylectomy side. This method is applicable in cases in which facial asymmetry originates solely from unilateral condylar overgrowth, and the maxilla and mandible are presumed to have been in the normal class I anteroposterior position before the onset of condylar lesion growth. After surgery, temporomandibular joint pain and/or mouth limitations were resolved, the new condyle showed satisfactory bone remodelling, and favourable facial symmetry was attained. The postoperative results were maintained long-term and there was no recurrence on the condylectomy side. This simply modified surgical strategy for facial asymmetry due to unilateral condylar overgrowth may be used in selected patients, regardless of the origin of the condylar lesion.
单侧髁突过度生长会导致严重的面部不对称。因此，治疗重点在于消除髁突病变以及矫正面部不对称。本报告的目的是介绍三例患者病例，引入一种更简单的手术方法、该手术方法的适应证以及一种无论髁突病变起源如何都始终适用的治疗计划流程。髁突切除术与正颌手术同时进行，选择垂直升支截骨术作为升支手术方法；在髁突切除侧未进行同侧升支手术。该方法适用于面部不对称仅源于单侧髁突过度生长且在髁突病变生长开始前上颌和下颌被推测处于正常I类前后位置的病例。术后，颞下颌关节疼痛和/或张口受限得到缓解，新的髁突显示出令人满意的骨重塑，面部对称性良好。术后结果长期保持，髁突切除侧无复发。这种针对单侧髁突过度生长导致的面部不对称的简单改良手术策略可用于特定患者，无论髁突病变的起源如何。
