Abstract| Volume 46, SUPPLEMENT 1, 223, March 2017

Is facial symmetry attainable after “high condylectomy only” in patients with unilateral active condylar hyperplasia?

      Background: Condylar hyperplasia (CH) causes various degrees of facial asymmetry and occlusal changes. The treatment of inactive CH is orthognathic surgery, whereas active CH requires in addition, high condylectomy to stop the hyperplastic condylar growth. Some authors reported high condylectomy to be also effective in achieving facial symmetry with no need for additional orthognathic surgery.
      Objective: To determine the degree of correction of facial asymmetry in CH after high condylectomy only.
      Methods: Ten patients with unilateral active CH were treated by condylectomy (removal of superior 5–8 mm of condyle) that was not followed by orthognathic surgery. Preoperatively, patients were classified as mild, moderate, and severe facial asymmetry according to the triangular analysis of the PA cephalogram as described by Reyneke. PA cephalograms and en-face photographs taken approximately one year after surgery were compared to baseline records.
      Findings: Four patients with mild facial asymmetry achieved excellent symmetry after high condylectomy and did not require further orthognathics. The other six patients with either moderate or severe facial asymmetry improved to various degrees after condylectomy, however, did not attain a satisfactory symmetric result, and three of them requested a secondary orthognathic surgery.
      Conclusion: Active condylar hyperplasia with mild facial asymmetry could be treated sufficiently with high condylectomy only, whereas moderate and severe degrees of facial asymmetry will benefit from the addition of orthognathic surgery. Surgeons could predictably determine based on the PA cephalometric analysis which patients will be sufficiently treated with high condylectomy only and which will require the addition of orthognathic surgery.