• 대한치과의사협회지
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• 제24권5호통권204호
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• pp.439-447
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• 1986

The occurrence of osteochondroma, osteoma in mandibular condlye is rare. Sign and symptoms of enlargement of condyle are open bite, cross bite, myofascial symptoms, facial asymmetry. They are treated via condylectomy, subcondylar ostetomy, etc. We treated osteochondroma with condylectomy, osteoma with condylectomy & arthroplasty with titanium mesh & resin ball. Followings are the results 1. Condylectomy of osteochondroma resulted in good function & esthetics except slight deviation of mandible to the operation side during mouth opening. 2. Condylectomy & arthroplasty with titanium mesh & resin ball resulted in good function & esthetics & no deviation of mandible.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권2호
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• pp.200-207
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• 1996

In patients with unilateral condylar hyperplasia, increased length of the condylar neck causes deviation of the mandible to the opposite site, resulting in facial asymmetry, but the arch form and general contour of the displaced mandible is approximately symmetric. So, the unilateral condylectomy have been prefered surgical method among the surgeons. The purpose of this study is to analyze the postoperative results comparatively following two different surgical methods, condylectomy and ramus surgery, in unilateral condylar hyperplasia. Case of 6 patients with the unilateral condylar hyerplasia were analyzed in this study, 3 case of the condylectomy only, 3 cases of the ramus surgery, Clinical and radiographic evaluations were tried for comparison. In conclusion, comparative results between two groups did not show any significant difference, but we confirmed that unilateral condylectomy could be a excellent surgical methods in unilateral condylar hyperplasia thinking over the unique morphological characteristics of it.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권5호
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• pp.259-264
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• 2015

We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.23.1-23.8
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• 2015

Background: The purpose of this study was to investigate the functional effects of temporalis myofascial flap after condylectomy, with or without disc removal, in elderly patients with anterior disc displacement (ADD) without reduction and an erosive condylar surface of the temporomandibular joint (TMJ). Methods: A total of 15 joints from 11 elderly patients (71-78 years old) were included. The patients had pain, mandibular dysfunction symptoms, and unilateral or bilateral ADD as well as an erosive condylar surface of the TMJ. All patients underwent temporalis myofascial flap reconstruction after condylectomy, with or without disc removal. If the maximal mouth opening (MMO) remained <35 mm after condylectomy, coronoidotomy was also performed. Self-assessed pain and mandibular function, including MMO and protrusive and lateral movements, were evaluated. Results: No patient experienced serious complications. Most measurements improved significantly after surgery compared to preoperatively. Most patients achieved nearly-normal mouth opening at 4 weeks after surgery. Although most patients felt discomfort during active postoperative physiotherapy, no patient reported serious pain during the follow-up period. Conclusion: Although nonsurgical therapy is often the first treatment choice for ADD without reduction of the TMJ, surgical intervention involving condylectomy and temporalis myofascial flap reconstruction may be a reasonable first option for elderly patients with an erosive condylar surface of the TMJ.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.233-240
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• 2007

Osteochondroma is a common benign tumor of the axial skeleton, especially the distal metaphysis of the femur and proximal metaphysis of the tibia. However, it occurred rarely on the facial skeleton. The coronoid and condylar processes have been considered to be the most common sites of occurrence for osteochondroma of the facial skeleton. The first treatment of osteochondroma is condylectomy, whereas extirpation was done by excision with condyle salvage. Condylectomy presents decrease of vertical dimension, jaw deviation, malocclusion. So, reconstruction is need. Methods of reconstruction are as follows: no reconstruction, condyloplasty, discectomy, costochondral graft, discplication or coronoidectomy, eminoplasty, alloplastic spacer placement, Le Fort I level maxillary osteotomy, extraoral and intraoral vertical ramus osteotomy. This is a case report of a 28-year old woman who had facial asymmetry, malocclusion and temporomandibular joint pain. We obtained moderate functional and cosmetic results with surgical removal of the osteochondroma by condylectomy and concomitant reconstruction of condyle by vertical ramus osteotomy with sliding technique.

• 대한치과교정학회지
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• 제38권6호
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• pp.437-455
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• 2008

과두과증식은 하악의 3차원적인 골격적인 비대가 일어나는 병적인 상태이다. 이러한 과두과증식의 원인은 호르몬의 작용, 외상, 감염, 유전, 태아기 때의 요인, hypervascularity 등의 요인으로 알려져 있다. 과두과증식의 진단 시 가장 중요한 것은 과두과증식 상태가 아직도 활성화 상태인지 판단하는 것이다. 이러한 과두과증식의 상태에 따라서 안면비대칭 환자의 치료는 이환측 과두의 성장 부위를 제거하는 과두절제 술을 시행하는 방법, 성장이 완료될 때까지 기다렸다가 통상적인 악교정 수술만을 시행하거나 과두절제술을 병행하는 시술방법이 있다. 과두과증식의 활성화 상태를 판단하는 것은 치료 안정성에 매우 중요한 요인이며, bone scan이나 주기적인 3차원 컴퓨터 단층촬영이나 정모 두부방사선사진 등을 통하여 확인할 수 있다. 본 보고에서는 과두과증식을 동반한 안면비대칭 환자를 과두절제술를 이용하여 개선한 증례를 소개하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권2호
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• pp.191-198
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• 1991

안모비대칭은 심미적 정서적으로 영향을 줄 뿐만 아니라 기능적인 장애를 초래하는 경우도 있다. 안모비대칭은 안면골 중에서 특히 하악골과 관련된 경우가 많은데 이는 하악골이 안면하부의 연조직을 지지하므로 작은 위치, 형태 변화에도 두드러지게 나타나기 때문이다. 비대칭안모를 초래하는 하악과두의 거대증은 Hyperplasia, Hypertrophy, 골증, 외골증, 골연골증, 연골육종 등을 들 수 있다. 비대칭안모 분류는 여러 학자에 의해 다양하게 분류되지만 Bruce와 Hayward는 Deviation prognathism, Unilateral macroganthia, Unilateral condylar hyperpiasia로 분류한 바 있다. 과증식된 하악과두의 절제술은 1856년 Humphry에 의해 최초로 시행된 후 여러 학자들에 의해 성공적으로 시행되고 있다. 본 증례에서는 Unilateral condylar hyperlpasia와 골연골종으로 인한 안모비대칭 환자로써 Condylectomy, Le Fort I osteotomy, Vertical ramus osteotomy, Mandibular inferior border ostectomy, Genioplasty 등을 시행하여 심미적 기능적으로 양호한 결과를 얻었기에 이를 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.4.1-4.6
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• 2015

Osteochondroma is rarely reported in the maxillofacial region; however, it is prevalent in the mandibular condyle. This slowly growing tumor may lead to malocclusion and facial asymmetry. A 39-year-old woman complained of gradual development of anterior and posterior unilateral crossbite, which resulted in facial asymmetry. A radiological study disclosed a large tumor mass on the top of the left mandibular condyle. This bony tumor was surgically removed through condylectomy and the remaining condyle head was secured. Subsequently, bimaxillary orthognathic surgery was performed to correct facial asymmetry and malocclusion. Pathological diagnosis was osteochondroma; immunohistochemistry showed that the tumor exhibited a conspicuous expression of BMP-4 and BMP-2 but rarely expression of PCNA. There was no recurrence at least for 1 year after the operation. Patient's functional and esthetic rehabilitation was uneventful.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권5호
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• pp.305-309
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• 2012

Temporomandibular joint (TMJ) subluxation and dislocation are uncommon but very unpleasant and distressing conditions to patients. Subluxation of the TMJ is an excessively abnormal condylar excursion secondary to flaccidity and laxity of the capsule. When the condyle head excurses anterior to the eminence upon wide opening, it can return to the fossa by self-manipulation or non-surgical conservative reduction. Surgery is recommended if a complete dislocation, so-called open lock, occurs as a chronic or recurrent protracted condition that cannot be reduced voluntarily. A range of surgical procedures can be performed to limit condylar hypermobility inclusing soft tissue tethering, creation of articular obstacles, removal of mechanical blockade and augmentation of articular eminence using different kinds of grafts. In the present case, a 74-year-old woman was diagnosed with a chronic TMJ dislocation that had lasted for 6 months. Bilateral condylectomy was performed and the post-operative results were good without functional limitations or recurrence.

• Archives of Plastic Surgery
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• 제42권6호
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• pp.716-720
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• 2015

Background This study has been conducted with the aim of evaluating modified T-plate interpositional arthroplasty. Methods A prospective comparative study in patients admitted with temporomandibular joint ankylosis. Ankylotic temporomandibular joint arthroplasty included condylectomy gap arthroplasty in 7, temporalis muscle flap interpositional arthroplasty in 8, and modified T-plate interpositional arthroplasty in 13 cases. The patients were followed for three years. Collected data were tabulated and subjected to Fisher's exact test, chi-square test and probability estimation. Results A significant increase in interincisal distance of 32 mm was seen in 12 (92.31%) patients in the T-plate interposition group, in 2 (25%) cases of the temporalis muscle flap interposition group, and in 1 case (14.28%) of the condylectomy group at 12, 24, and 36 months. Re-ankylosis was observed in 1 case (9.69%) of the T-plate interposition group, while as it was observed in 4 (50%) cases in the temporalis muscle flap interposition group and 4 (57.14%) cases in the condylectomy group, and these differences were statistically significant. Conclusions Our clinical experience with the use of the T-plate over the past 5 years has been encouraging, and our physiotherapy technique is quite simple. Even illiterate parents can assess it easily. Hence, we recommend this easy technique that does not damage the temporalis muscle for the management of temporomandibular joint ankylosis.