Functional results after condylectomy in active laterognathia.
BACKGROUND
Mandibular asymmetry due to overgrowth has two main forms, hemimandibular hyperplasia and hemimandibular elongation. It is necessary to distinguish between inactive and active forms, since surgical treatment of the latter, with a solely morphological aim, could lead to recurrence of further condylar growth. In these cases orthognathic surgery is performed in association with high condylectomy to interrupt the hyperactivity of the condyle. Condylectomy alone in growing patients stops the progression of deformities and sometimes achieves facial symmetry at the end of growth. Some authors have viewed condylectomy as a dangerous procedure, with the possibility of compromising articular function. We aimed to verify immediate and long-term results of condylar function after high condylectomy.


METHODS
Between 1998 and 2007, 15 patients underwent high condylectomy for active laterognathia. All but one patient underwent postoperative Delaire functional rehabilitation. Long-term articular function was evaluated using subjective and objective criteria.


RESULTS
In 14 patients, articular function was subjectively satisfactory. In one case, this did not occur because the patient refused postoperative functional rehabilitation.


CONCLUSIONS
Some authors have advised against condylectomy because of the possibility of temporomandibular joint dysfunction. High condylectomy in active laterognathia seems to be the procedure of choice in both adults and growing patients. In our experience, functional alterations of practical relevance are rare if the operation is followed by successful functional rehabilitation.
Brusati
Roberto
R
Department of Maxillofacial Surgery (Head: Prof. Dr. R. Brusati), University of Milan, Milan, Italy.
Pedrazzoli
Marco
M
Colletti
Giacomo
G
D000293:Adolescent; D000328:Adult; D002648:Child; D005146:Facial Asymmetry / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D006965:Hyperplasia; D007569:Jaw Abnormalities / Q000534:rehabilitation / Q000601:surgery; D019248:Jaw Fixation Techniques; D008297:Male; D008334:Mandible / Q000002:abnormalities*; D008335:Mandibular Condyle / Q000601:surgery*; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D013704:Temporomandibular Joint / Q000502:physiology*; D055815:Young Adult