Abstract
BackgroundMandibular condylar osteochondroma (OC) could lead to facial morphologic and functional disturbances, such as facial asymmetry, malocclusion, and temporomandibular joint dysfunction. However, after condylar OC resection, the inaccurate reposition of the neocondyle still needs to be solved. The purpose of this study was to explore the feasibility of the condylar osteotomy and repositioning guide to reposition the neocondyle in the treatment of patients with severe deformity secondary to condylar OC.ResultsThree patients with severe deformity secondary to OC of the mandibular condyle were enrolled in this study. With the aid of condylar osteotomy and repositioning guide, condylar OC resection and repositioning were carried out, and the accuracy and stability of these guides were evaluated. All patients healed uneventfully, and no facial nerve injury and condylar ankylosis occurred. Compared with the computerized tomography scans in centric relation before surgery and 3 days after surgery, the results showed that the facial symmetry was greatly improved in all the patients. Also, after the superimposition of the condylar segments before surgery and 3 days after surgery, the postoperative reconstructed condyles had a high degree of similarity to the reconstruction of the virtual surgical planning. Observed from the sagittal and coronal directions, the measurements of condylar positions were very close to those of virtual surgical planning. Moreover, it also showed stable results after a 1-year follow-up.ConclusionsFor patients with severe deformity secondary to condylar OC, condylar osteotomy, and repositioning guide was expected to provide a new option for the improvement of facial symmetry and occlusal relationship.
Highlights
Osteochondroma (OC), a kind of osteocartilaginous exostosis, is considered as the common tumor of long bones, comprising approximately 35 to 50% of all benign bone tumors [1, 2]
Our previous study demonstrated that endoscope-assisted condylar OC resection combined with simultaneous contralateral sagittal split ramus osteotomies (SSRO) could be chosen in the treatment of asymmetric prognathism secondary to condylar OC [10]
The retrospective study showed that the combination of conservative condylectomy via the intraoral approach based on the endoscope and simultaneous contralateral SSRO is effective in improving the facial symmetry in the treatment of the condylar OC [11]
Summary
Osteochondroma (OC), a kind of osteocartilaginous exostosis, is considered as the common tumor of long bones, comprising approximately 35 to 50% of all benign bone tumors [1, 2]. For condylar OC resection, the preauricular incision alone or in combination with cervical incisions is the most common option [7]. This approach is associated with an increased risk of facial nerve injury, and it tends to leave the scar on the face [8]. Our previous study demonstrated that endoscope-assisted condylar OC resection combined with simultaneous contralateral SSRO could be chosen in the treatment of asymmetric prognathism secondary to condylar OC [10]. The retrospective study showed that the combination of conservative condylectomy via the intraoral approach based on the endoscope and simultaneous contralateral SSRO is effective in improving the facial symmetry in the treatment of the condylar OC [11].
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