Sfondrini Domenico, Marelli Stefano, Patriarca Rachele, Luzzi Sabino, Beltramini Giada, Preda Lorenzo, Savioli Gabriele, Sfondrini Francesca
Maxillofacial Unit, Emergency Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Neurosurgery Unit, Head and Neck Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Acta Otorhinolaryngol Ital. 2024 Dec;44(6):412-420. doi: 10.14639/0392-100X-N3119.
Osteochondroma (OC) is a common bone tumour that rarely affects the mandibular condylar process. This pathology can show typical clinical features, such as facial asymmetry, deviation of the chin and dental inferior midline, changes in condylar morphology and malocclusion with an increased posterior mandibular vertical height. The management of condylar OC is a debated topic among surgeons. Most of them combine systematically condylectomy with orthognathic surgery while only few others perform in the first instance only condylectomy followed by functional therapy. A case of a 32-year-old female diagnosed with a mandibular condylar OC successfully treated with condylectomy alone is presented. A literature review is carried out focusing on surgical management, clinical and imaging features, highlighting the differences between OC and other condylar growing lesions. When maxillary alterations are not present or are mild as in the presented patient, the low condylectomy alone, followed by elastic functional therapy, can correct both the aesthetic and the occlusal disorders resulting from condylar OC removal. In case of severe dentoalveolar maxillary compensation, orthognatic surgery must be performed with the low condylectomy to quickly correct facial symmetry and occlusion.
骨软骨瘤(OC)是一种常见的骨肿瘤,很少累及下颌髁突。这种病变可表现出典型的临床特征,如面部不对称、颏部偏斜和牙部下中线偏移、髁突形态改变以及下颌后垂直高度增加导致的错牙合。髁突OC的治疗是外科医生之间存在争议的话题。大多数医生系统地将髁突切除术与正颌手术相结合,而只有少数医生首先仅进行髁突切除术,然后进行功能治疗。本文介绍了一例32岁女性下颌髁突OC患者,仅通过髁突切除术成功治疗的病例。进行了一项文献综述,重点关注手术治疗、临床和影像学特征,突出了OC与其他髁突生长性病变之间的差异。当上颌改变不存在或如本文患者那样轻微时,单独进行低位髁突切除术,随后进行弹性功能治疗,可纠正因髁突OC切除导致的美学和咬合紊乱。在存在严重牙-牙槽上颌代偿的情况下,必须在低位髁突切除术的基础上进行正颌手术,以快速纠正面部对称性和咬合关系。