Chang Gung Memorial Hospital, T’ai-pei, Taipei, Taiwan Plastic & Reconstructive Surgery
(Impact Factor: 2.99).
05/1996; 97(4):730-7. DOI: 10.1097/00006534-199604000-00007
True hemimandibular hyperplasia is an uncommon maxillofacial deformity. Patients with this affliction present clinically with varying degrees of asymmetry characterized by an increase in ramus height, a rotated facial appearance with kinking at the mandibular symphysis, and prominence of the lower border of the mandible. In the advanced form, maxillary and mandibular alveolar bone overgrowth result in a compensatory canting of the occlusal plane and a significant functional malocclusion requiring bimaxillary surgical correction. Nine patients with the above condition were treated with various surgical methods over a 9-year period. The clinical results were satisfying and the long-term results showed good postoperative stability. The pathology of hemimandibular hyperplasia is described and the preexisting nomenclature further defined.
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- "[9,19,20] KH'yi; mandibüler anomalileri ve kondiler tümörleri dahil ederek sınıflandırmışlardır. Obwegeser ve Makek  ise " kondiler hiperplazi " teriminin sadece kondilin hiperplazisini tanımladığını, mandibüler büyümenin eşlik ettiği durumların, soliter KH'den ve birbirlerinden farklı mandibüler anomaliler olduğunu bildirmiş ve bu temelde mandibüler anomalileri sınıflandırmışlardır . Chen ve ark.  kanıtlanamamasına rağmen, tedavi edilmeyen soliter KH'nin HH ya da HU'ya ilerlemesinin mümkün olduğunu ileri sürmüş ve bu nedenle " kondiler hiperplazi " teriminin mandibüler deformite oluşmadan önce kullanılmasını, HH ve HU terimlerinin ise bu anomalilerin klasik özellikleri görüldüğü zaman kullanılmasını önermişlerdir. Soliter KH olan olgu 1 ile HU olan olgu 2 arasında klinik ve radyografik görünümün yanı sıra gelişim yaşı açısından da bir farklılık bulunmaktadır . "
- "As it has been put forward that if this condition is managed at an early stage, the mandibular and facial deformity seems to be arrested. On the other hand some authors believe that CH may ultimately progress to hemimandibular hyperplasia or hypertrophy, however no scientific study has yet been able to confirm such views (Yu-Ray Chan 1995). "
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ABSTRACT: Condylar hyperplasia of the mandible is a clinical condition of over-development and growth because of excessive cellular growth of one condylar part of the mandible leading to facial asymmetry, mandibular deviation and enlargement of condyle. The elongation of the condylar neck in turn leads to malocclusion and articular dysfunction. In the past the interceptive and corrective procedures of growth and deformity in condylar hyperplasia were either condylectomy or high condylotomy. However, the deformity ceases after growth is completed. Therefore, other surgical procedures have to be undertaken to correct the manifested deformity of condylar hyperplasia. Further it has to be stressed that no single procedure can completely correct the deformity. So in addition to condylectomy, other orthognathic surgical procedures both on body and ramus and also on maxilla can be undertaken to correct the canting of occlusion. Two rare cases of unilateral hyperplasia encountered in our hospital are presented which required different lines of treatment.
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- "In cases with nonactive enlargement and acceptable movement of the condyle, the condyle should be preserved and the joint capsule should not be violated. There have been a few reports of complications in the case of condylectomy: anterior open bite, lateral precontact treated by cup grinding, deviation to the operated side when opening the mouth (Hampf et al., 1985), and loss of lateral excursion on the operated side because of the failure or reinsertion of the lateral pterygoid muscle to the neocondyle (Chen et al., 1996). Motamedi (1996) reported that patients with unilateral CH of the mandible and deviation can be treated favorably by unilateral ramus osteotomy of the affected side and that bilateral ramus osteotomy did not have any advantage in such cases . "
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ABSTRACT: To present a case of hemimandibular hyperplasia (HH) treated with orthognathic surgery that preserves the condyle without disturbing mandibular function.
A 27-year-old woman with HH was treated with orthognathic surgery preserving the enlarged condylar head. Radiographic examination showed typical enlargement of the right condyle, elongation of the right ascending ramus and mandibular body, and tilted occlusal plane. A mandibular sagittal split osteotomy on the unaffected side and subcondylar ramus osteotomy on the affected side, Le Fort I wedge osteotomy to relevel the tilted occlusal plane, and contouring of the lower mandibular margin were performed.
Excellent results in the full-face appearance and occlusion were obtained. There was no change in the size of the reserved condylar head 4 years postoperatively. In a series of examinations of jaw function with electromyography, mandibular kinesiography, and computer-aided diagnostic axiography, more favorable findings were obtained postoperatively.
In a case of HH without abnormally high growth activity, orthognathic surgery preserving hypertrophic condyle produced functional improvement in addition to good occlusal and aesthetic outcomes.
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