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[接受髁突切除术治疗单侧髁突肥大患者的颞下颌关节临床及影像学评估。病例系列研究]

[Clinical and imagenological evaluation of the temporomandibular joint in patients undergoing condylectomy for the treatment of unilateral hyperplasia. Case series study].

作者信息

Laguna-Monagas Héctor Andrés, Hernández-Andara Adalsa, Ortega-Pertuz Ana, Cordsen Hans, Gudiño Ronar, Contreras Carlos

机构信息

Programa de Cirugía y Traumatología Bucal y Maxilofacial, Hospital General del Oeste Doctor José Gregorio Hernández. Caracas, Venezuela.

Unidad de Diagnóstico por Imagen, Clínica Félix Boada. Caracas, Venezuela.

出版信息

Rev Cient Odontol (Lima). 2021 Dec 9;9(4):e090. doi: 10.21142/2523-2754-0904-2021-090. eCollection 2021 Oct-Dec.

Abstract

Unilateral condylar hyperplasia is a non-neoplastic and self-limiting overgrowth of the mandibular condyle that usually begins during puberty, predominates in women and is considered an aberration of the normal growth mechanism of the condyle. This abnormal growth continues until the mid-20s and produces mandibular prognostism, facial and occlusal asymmetry with progressive displacement of the mandible to the contralateral side. The purpose of this report was to describe the cases of two female patients (23 and 25 years old) with unilateral condylar hyperplasia treated with high condylectomy and orthognathic surgery, with emphasis on clinical and imaging aspects and late post-surgical follow-up. Both patients presented satisfactory cosmetic results, without pain / noise related to the temporomandibular joint, mouth opening within the normal range, and class I canine and molar relationship. Computed tomography showed signs of remodeling in the affected condyle. High condylectomy combined with orthognathic surgery is an adequate treatment in cases of unilateral hyperplasia, restoring functionality and aesthetics to the patient. The bone remodeling observed in the intervened condyles seems to indicate that the condylar head maintains its adaptive capacity even in adult patients.

摘要

单侧髁突增生是下颌髁突的一种非肿瘤性、自限性过度生长,通常始于青春期,女性多见,被认为是髁突正常生长机制的一种异常。这种异常生长持续到25岁左右,导致下颌前突、面部和咬合不对称,下颌逐渐向对侧移位。本报告的目的是描述两名女性患者(分别为23岁和25岁)单侧髁突增生接受高位髁突切除术和正颌手术治疗的病例,重点关注临床和影像学方面以及术后晚期随访情况。两名患者均获得了满意的美容效果,无颞下颌关节相关疼痛/弹响,开口度在正常范围内,尖牙和磨牙关系为Ⅰ类。计算机断层扫描显示患侧髁突有重塑迹象。高位髁突切除术联合正颌手术是单侧增生病例的一种有效治疗方法,可恢复患者的功能和美观。在接受手术干预的髁突中观察到的骨重塑似乎表明,即使在成年患者中,髁突头部仍保持其适应能力。

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