Two-Stage Treatment of Facial Asymmetry Caused by Unilateral Condylar Hyperplasia

Condylar hyperplasia (CH) is a rare, self-limiting process manifesting between the first and third decades of life. CH causes facial asymmetry and derangement of the occlusion. Management involves resection of the condylar head and orthognathic surgery. This paper describes the case of a 37-year-old woman with spontaneous onset of CH over a span of approximately 25 years. The condition was managed with resection of the condyle alone, which dramatically improved facial asymmetry and altered the occlusion within a few months of follow up. Orthodontic treatment was then carried out and the patient underwent orthognathic surgery after 3 years. The patient is currently satisfied with her appearance and function and there are no signs of recurrence.

Hiperplasia condilar (HC) é um processo raro e auto-limitativo que ocorre entre a 1a e a 3a décadas de vida. Ela causa assimetria facial e alteração da oclusão. O tratamento envolve ressecção da cabeça do côndilo e cirurgia ortognática. Este artigo descreve o caso de uma mulher de 37 anos com início espontâneo de HC e duração de aproximadamente 25 anos. O tratamento foi feito com ressecção apenas do côndilo, o que melhorou consideravelmente a assimetria facial e a oclusão em poucos meses de acompanhamento. Seguiu-se o tratamento ortodôntico e a paciente foi submetida a cirurgia ortognática três anos depois. Atualmente a paciente está satisfeita com sua aparência e função, sem apresentar sinais de recorrência.

An Investigation of Articular Cartilage Degeneration Induced by Compression-Immobilization and Condylar resection of Knee Joint in Rabbits / 대한정형외과학회잡지

Articular cartilage have dual functions of shock absorber and bearing surface in a moving joint. Articular cartilage is avascular, so the chondrocytes in mature adult must receive their nourishment solely from synovial-fluid perfusion, and it is known that alteration of synovial-fluid perfusion causes degeneration of articular cartilage. Now, in orthopedic fields, the corrective cast immobilization and traction is in popular use. In order to study the cartilage changes induced by this long-term cast immobilization and traction, compression-immobilization and condylar resection of knee joint in rabbits were performed, and weekly histoiogic examinations of articular cartilage up to 5 weeks were followed. The observations were as follows: 1. Degenerative changes of articular cartilage were observed respectively with compression-immobilization and condylar resection, and the severity of the histologic changes appeared to be proportional to the duration of compression-immobilization and condylar resection. 2. Earlier degenerative changes of articular cartilage in condylar resection group than in compression-immobilization group were noted, and this earlier degenerative changes in condylar resection group suggests that hemarthrosis may play a role in cartilage degeneration. 3. Histologically unchanged calcific cartilage zone and mildly hypertrophied subchondral bone were noted in compression-immobilization group, but vascular invasion to calcific cartilage zone and subchondral osteoporosis were noted in condylar resection group.