1990 Volume 36 Issue 2 Pages 400-411
In this paper, a case of osteochondroma originated in the left mandibular condyle of a 56-year-old man is reported.
Clinical examination revealed marked lower facial asymmetry and malocclusion with the mandible deviated 18 mm to the right. Radiograms revealed an oval, pedunculate, radioopaque mass attached to the anteromedial aspect of the condyle. The condyle head was displaced forward under the articular tubercle. The patient was surgically treated in a temporal approach by resecting zygomatic arch temporarily and resecting the tumor protruded into the medial side of lateral pterygoid muscle from the condyle head. The patient has been followed for three years. The symmetry of the face and occlusion was greatly improved.
Excessive unilateral growth of the mandibular condyle with occlusal disturbances and facial asymmetry has been reported in patients with hyperplasia, hyperostosis, hypertrophy, osteoma, osteochondroma, and so on. The differences between these disease entities are still obscure. Therefore, cases of these diseases in the literatures concerned have been collected and the clinical features analyzed.
As the result, these cases could be classified into hypertrophic type and nodular type. The former is characterized by morphological feature of elongation or hyperplasia of the condyle itself. In contrast, the latter shows a morphological feature of nodular protrusion from the condyle head into the lateral pterygoid muscle without elongation of the condyle itself. The onset age of the lesion and several clinical characteristics differ between the two types, therefore, different treatment methods should be considered.
