Unilateral mandibular condylar osteochondroma treated with ipsilateral condylectomy and contralateral ramus osteotomy

We successfully treated a case of facial asymmetry involved in unilateral mandibular condylar osteochondroma with ipsilateral mandibular condylectomy and contralateral ramus osteotomy. A female, 32-year 11-month of age, had a chief complaint of facial asymmetry which initiated about 10 years ago. A mirror image analysis using a non-contact 3D image scanner revealed that the soft tissue on the deviated side was protruded more than 5.50 mm compared with the non-deviated side. The patinet was diagnosed as facial asymmetry with a skeletal Class III jaw-base relationship caused by unilateral mandibular condylar osteochondroma. After 18 months of preoperative orthodontic treatment, ipsilateral condylectomy and contralateral sagittal split ramus osteotomy were performed. As the results of postoperative orthodontic treatment for 20 months, an ideal occlusion having a Class I molar relationship with an adequate interincisal relationship was achieved. Facial asymmetry and mandibular protrusion were dramatically improved, and the differences between the deviation and non-deviation sides were decreased to less than 1.11 mm. The acceptable occlusion and symmetric face were maintained throughout 1-year retention period. Conclusively, our results indicated the stability after condylectomy without condylar reconstruction in a patient with unilateral condylar osteochondroma.

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