| Condylar hyperplasia(CH), also be named as hemimandibular hyperplasia(HH), hemimandibular elongation(HE),asymmetry hypertrophy, Sturge-Weber syndrome. CH is a rare disease in clinical.Robert Adams first discovered and recorded it in1836. CH is described as mandible tridimensional augmentation. Generally, it contains condyle and the ramus on the affected side. The lower mandibular border is asymmetrical. The lower jaw deviates to the healthy side.The occlusal plane is tilted. There is a consensus that the growth in one of the condyles may be prolonged by activity of the condyle, after the end of general skeletal growth.However, such as hormonal influences, hypervascularity, heredity, infection or trauma has considered as an additional factors.The aim of this study is to expound the differences of condylar remodeling effection after extro-/intro-oral approaches condylectomy, as well as temporomandibular joint function after condylectomy. To measure the patients’ soft-and hard-tissue facial asymmetry index pre-operation and follow-up after condylectomy, and evaluate the correction between them.Part1:Simultaneous correction of soft-and hard-yissue facial asymmetry after condylectomyPurpose:To measure the patients’ soft-and hard-tissue facial asymmetry index pre-operation and follow-up after condylectomy. And evaluate the correction between them.Methods:Condylar hyperplasia patients treated with condylectomy operation. The distance between preaureculare, gonion (Go’), mesion point(Me’) to midsagittal line and Go’-Me’ in the soft-tissue, and corresponding point in the hard-tissue,was measured. There was paired t-test and correlation Pearson-test between groups, after asymmetry indices(AI) were calculated.Results:The paired t test, only the preauricular points (AI) P>0.01. The distance between preaureculare and.condylar point to midsagittal (AI) correlation coefficient r=0.933, gonion (AI) r=0.984,mandibular body (AI) r=0.997, mesion(AI) r=0.997and mandibular ramus (AI) r=0.645.Conclusion:1) Condylectomy can treated facial asymmetry effectively;2) Soft-and hard-tissue have a higher correlation after long-term follow-up;3) The mandibular ramus deformity improvement is not completely equivalent between soft-and hard-tissuePart2:Evaluation of temporomandibular joint function after condylectomy for condylar hyperplasiaPurpose:To investigate the temporomandibular joint(TMJ) function of the condylar hyperplasia patients after condylectomy.Methods:14patients with condylar hyperplasia were included in this study. Before and after condylectomy, they were examined and the Fricton’s Craniomandibular Index (CMI) was calculated to assess the functional disorder of TMJ.Results:The facial asymmetry was improved after condy lectomy. The morphological symmetry of the bilateral condyle and ramus was displayed by X’ray ex aminations.There was new cortex formed on the surface of the operated condyle. The TMJ function was improved in terms of Fricton’s DI and CMI, which decreased from0.15and0.11to0.031and0.025respectively (P<0.05).Conclusion:Condylectomy is an effective method to remedy facial asymmetry and, at the same time, improve the TMJ function of the condylar hyperplasia patients. Part3:Condylar remodeling after condylectomy by Intra-oral/Extra-oral approachesPurpose:Evaluate facial asymmetry and condylar surface remodeling after intra-oral and extra-oral condylectomy with condylar hyperplasia(CH) patients.Methods:24cases (left side:right side=14:10) were diagnosing CH with a chief complaint in facial asymmetry and occlusal disturbance. All patients received condylectomy of the affected side (11extra-oral and13Intra-oral) and average follow-up interphase was11.7months. These patients had made the clinical and radiography examinations, including TMJ function, facial symmetry, mandibular ramus length and condylar surface changes.Results:There were no significant differences between extra-oral and intra-oral group according to MMO, joint clicking and pain. The mean for affected side ramus length in extra-oral group was7.09±0.61cn pre-surgery and6.63±0.60cm post-sugery, while6.83±0.55cm and6.48±0.54cm in intra-oral group. And6.59±0.61cm and6.50±00.49cm were measured in the follow-up. The extra-oral group showed an average AI of2.81±1.63by total mandibular length and3.34±1.88by mandibular ramus height. These were measured in follow-up for1.89±1.75and2.17±1.11. The intra-oral group showed an average AI of3.43±1.98,3.73±1.82in post-operation, and2.27±1.91,1.92±1.48in follow-up. No significant difference was observed regarding these dateConclusion:Condylectomy by intra-oral approach have a similar effectiveness in preventing facial asymmetry development and mandibular ramus growth with extra-oral group. Meanwhile, the remodeling of the affected side in long-term results is acceptable. |
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