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Annals of Clinical Case Reports
2018 | Volume 3 | Article 1524 1
Introduction
Overdevelopment of mandible was described by Robert Adams in 1836 who related it to
condylar hyperplasia. Condylar hyperplasia of the mandible is an uncommon idiopathic disorder
of non-neoplastic origin of the jaw characterised by increased volume of the condyle, unilaterally
or bilaterally, leading to facial asymmetry, mandibular deviation, malocclusion and articular
dysfunction generally without pain [1].
Hugo Obwegeser and Makek classifed condylar hyperplasia as Type 1, 2, and 3. Wolford et
al developed an updated classifcation of condylar hyperplasia in 2014 [2] (Table 1). Condylar
hyperplasia has an unknown etiology. Several theories exist in the literature in which one states
that an event of a trauma leading to increase in number of repair mechanism and hormones in
that area may lead to increase in growth of mandible on that side [3]. Another theory states that an
increase in loading of Temporomandibular joint can lead to increase in expression of bone forming
molecules [4]. Condylar hyperplasia predominantly afects women 64% of patients being women
[2]. We report a unilateral condylar hyperplasia in 35 year old female managed successfully by
surgical intervention.
Case Presentation
A 35 year old female patient reported to us with a chief complaint of facial asymmetry. Her
antenatal and obstetric history was not contributory. She had a history of trauma to the lower jaw
during childhood for which she had not undergone any treatment. On extra-oral examination
patient had facial asymmetry, fattening seen on the lef side of the face with appearance of fullness
on right side of the face (Figure 1). A bony swelling in the lef pre-auricular region was evident
measuring about 1.5 cms x1.5 cms. On opening of the mouth patient had deviation of the lower jaw
towards the right side (Figure 2). On radiographic examination, OPG shows gross enlargement of
the lef condyle and Loss of antegonial notching with downward bowing of the inferior border on
the mandible (Figure 3). CT scan revealed a hyperplastic lef condyle with elongated neck (Figure
4). An outward and downward growth of the body and ramus of the mandible on the afected side,
deviation of mandible and chin to the opposite side, slanted occlusal plane for dental compensation,
and deviation of dental midlines were evident. Tere was asymmetry of the lef hemi mandible and
outward protrusion of the anterior teeth. As the hyperplastic mass of condyle was evidently extended
in the lateral preauricular region, it was easier to approach with preauricular incision (Figure 5a
and b). Dissection was carried out till the mass was reached and continued to expose the condylar
neck. Bony cut was made just below the hyperplastic mass which led to its separation from the neck
of the condyle (Fig 6a and b). Entire mass was carefully removed in Toto (Figure 7a and b). Te
raw condyle neck portion was rounded of to mimic the condylar head (Figure 5b). Wounds were
closed in layers. Post operatively, patient developed open bite on contra lateral side with premature
Unilateral Condylar Hyperplasia: A Case Report
OPEN ACCESS
*Correspondence:
Kalyani Gelada, B 101, Sujay Garden
Housing Society, Mukund Nagar, Pune
411037, India, Tel: 919960593911;
E-mail: gelada.kalyani@gmail.com
Received Date: 09 Apr 2018
Accepted Date: 02 Jun 2018
Published Date: 20 Jun 2018
Citation:
Gelada K, Halli R, Hebbale M,
Mograwala H, Sethi S, Patil VS.
Unilateral Condylar Hyperplasia: A
Case Report. Ann Clin Case Rep. 2018;
3: 1524.
ISSN: 2474-1655
Copyright © 2018 Kalyani Gelada. This
is an open access article distributed
under the Creative Commons Attribution
License, which permits unrestricted
use, distribution, and reproduction in
any medium, provided the original work
is properly cited.
Case Report
Published: 20 Jun, 2018
Abst ract
Condylar Hyperplasia (CH) is a bone disease characterized by the increased development of
mandibu¬lar condyle. It regularly presents as an active growth with facial asymmetry generally
without pain. Statistically it af¬fects more women in adolescence, although it does not discriminate
by age or gender. Its best-known consequence is Asymmetric Facial Deformity (AFD), combined
with alteration of the dental occlusion with unilateral crossbite or open bite. It is not known when
condylar hyperplasia begins and how long it lasts. We report a unilateral condylar hyperplasia in 35
year old female managed successfully by surgical intervention.
Keywords: Deviated mouth opening; Hyperplasia; Overgrowth of the mandible; Unilateral
crossbite
Kalyani Gelada*, Rajshekhar Halli, Manjula Hebbale, Husain Mograwala, Sanjana Sethi and
Viren S Patil
Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, India