Low condylectomy and functional therapy alone for unilateral condylar osteochondroma treatment: case report and literature review.

Abstract

Osteochondroma (OC) is a common bone tumour that rarely affects the mandibular condylar process. This pathology can show typical clinical features, such as facial asymmetry, deviation of the chin and dental inferior midline, changes in condylar morphology and malocclusion with an increased posterior mandibular vertical height. The management of condylar OC is a debated topic among surgeons. Most of them combine systematically condylectomy with orthognathic surgery while only few others perform in the first instance only condylectomy followed by functional therapy. A case of a 32-year-old female diagnosed with a mandibular condylar OC successfully treated with condylectomy alone is presented. A literature review is carried out focusing on surgical management, clinical and imaging features, highlighting the differences between OC and other condylar growing lesions.

When maxillary alterations are not present or are mild as in the presented patient, the low condylectomy alone, followed by elastic functional therapy, can correct both the aesthetic and the occlusal disorders resulting from condylar OC removal. In case of severe dentoalveolar maxillary compensation, orthognatic surgery must be performed with the low condylectomy to quickly correct facial symmetry and occlusion.