Use of conservative condylectomy for treatment of osteochondroma of the mandibular condyle.
OBJECTIVE
The aim of the present study was to present a conservative condylectomy technique (condylectomy performed below the condylar head but high in the condylar neck) and articular disc repositioning as the surgical treatment approach for management of osteochondroma of the head of the mandibular condyle.


METHODS
Six patients (4 females and 2 males) with an average age of 22.3 years (range, 13 to 32 years) and with an osteochondroma of the mandibular condyle were treated with conservative condylectomy. The remaining condylar neck stump was recontoured, and the articular disc was repositioned and stabilized over the "new" condyle. Any indicated orthognathic surgical procedures were then performed to optimize occlusion, function, and aesthetics. Clinical and radiographic evaluation was performed before surgery (T1), immediately after surgery (T2), and at the longest follow-up (T3).


RESULTS
Average follow-up for the patients was 51 months (range, 22 to 108 months). No recurrence of the tumor was encountered in any of the cases. Subjective and objective evaluations of postsurgical temporomandibular joint function and range of mandibular motion were normal. Associated maxillary and/or mandibular orthognathic procedures were found to be stable in the long term.


CONCLUSIONS
Conservative condylectomy with recontouring of the residual condylar neck to function as a condyle and repositioning of the articular disc is a viable option for treatment of osteochondromas of the mandibular condyle. The use of this method of treatment permits effective removal of the tumor and eliminates the need for autogenous grafts or total joint prostheses for temporomandibular joint reconstruction.
Wolford
Larry M
LM
Clinical Professor of Oral and Maxillofacial Surgery, Baylor College of Dentistry, Texas A&M University System, USA. lwolford@swbell.net
Mehra
Pushkar
P
Franco
Pedro
P
D000293:Adolescent; D000328:Adult; D005146:Facial Asymmetry / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000150:complications / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods*; D056948:Orthognathic Surgical Procedures; D015831:Osteochondroma / Q000150:complications / Q000601:surgery*; D019224:Temporomandibular Joint Disc / Q000601:surgery