Functional and psychosocial outcomes of simultaneous condylectomy and bimaxillary orthognathic surgery for unilateral condylar hyperplasia: Retrospective study

Abstract

Unilateral condylar hyperplasia (UCH) is a pathological growth disorder frequently associated with marked facial asymmetry. The objective of this study was to evaluate the functional and psychosocial outcomes of simultaneous high level or proportional condylectomy performed in conjunction with bimaxillary orthognathic surgery in individuals presenting with hemimandibular elongation or hyperplasia. Patient-reported outcomes were measured using the Orthognathic Quality of Life Questionnaire (OQLQ) and the Mandibular Function Impairment Questionnaire (MFIQ). Secondary outcomes included facial symmetry, aesthetic satisfaction, visibility of preauricular scars, limitation of mouth opening, temporomandibular joint (TMJ) pain and clicking, lower lip paresthesia (LLP), and facial nerve dysfunction. This retrospective analysis included 25 patients (19 females, 6 males; mean age 25.5 ± 5.41 years) who underwent simultaneous condylectomy (high level: n = 18; proportional: n = 2; with disc repositioning in 7 cases) and bimaxillary orthognathic surgery. Clinical and functional outcomes were assessed over a mean follow-up period of 3.5 ± 0.8 years. Statistically significant improvements were observed in both OQLQ and MFIQ scores following surgery (p < 0.001 for both). The majority of patients reported high satisfaction regarding facial symmetry and expressed minimal concern about preauricular scarring. TMJ pain and clicking, and LLP showed notable reduction or complete resolution. No major complications, including persistent facial paralysis, were encountered. Simultaneous condylectomy with bimaxillary orthognathic surgery demonstrates predictable and stable long-term outcomes in the management of unilateral condylar hyperplasia. This single stage approach effectively addresses both functional impairment and aesthetic concerns, eliminating the requirement for staged surgical procedures.