Post-Condylectomy Histopathologic Findings in Patients With a Positive 99mTc Methylene Diphosphonate Single-Photon Emission Computed Tomographic Diagnosis for Condylar Hyperplasia

Abstract

To describe and correlate with age the histopathologic findings observed in a group of specimens obtained from patients who underwent high condylectomy. In this cross-sectional study, 27 condylar specimens from patients with facial asymmetry, suspected condylar hyperplasia (CH), and a positive diagnosis by single photon emission computed tomography (SPECT) were evaluated. Histopathologic variables measured in the mandibular condyles were thickness of fibrous, proliferative, and hyperplasic cartilage layers and total tissue thickness. The thickness of the fibrous layer (P=.014) and proliferative layer (P=.005) and total thickness (P=.007) were significantly greater in the patients studied compared with the literature reference values, and 66.6% of cases presented cartilage islands in the calcified region. Seventeen patients no older than 22years (85%) showed this finding, whereas only 1 patient at least 23years old did. Therefore, the presence of cartilage islands was significantly related to age (P=.001). Altogether, the histopathologic findings are consistent with the positive SPECT diagnosis of CH. Histopathologic evaluation showed an increased thickness in the soft tissue layer of the affected mandibular condyle, which was particularly marked for the proliferative layer. Cartilage islands were found mostly in patients no older than 22years. Therefore, it is not a reliable pathognomic sign for CH because it could be related to normal condylar growth.