Facial asymmetry and condylar hyperplasia: considerations for diagnosis in 27 consecutives patients

Abstract

Facial asymmetry associated with condylar hyperplasia (CH) has been become the object of study in recent years. The aim of this study is to demonstrate the importance of analyzing the presence of CH in cases of facial asymmetry. Twenty-seven consecutive patients were studied without distinction of age or gender; all the patients consulted for treatment of facial and/or mandibular asymmetry and voluntarily agreed to participate in the study. All the patients underwent facial cone beam tomography and bilateral TMJ as well as a detailed history where they indicated the progression of the disease; in cases of active evolution determined by clinical analysis and imaging, a SPECT analysis was performed to define the isotope uptake. 29.6% of the subjects with scintigram exhibited active CH with a more than 10% difference in uptake between the two condyles; 18.5% presented differences in uptake between 5% and 10%. Active CH was related to the age and gender of the subjects, being more prevalent in women than in men. The aggression level of the uptake was also related to the subject's age. 55% of the subjects presented with some type of orthodontic treatment with no diagnosis of TMJ pathology in the initial consultation. It can be concluded that CH is associated with facial asymmetries and must be studied integrally before assessing treatment options.

Keywords: Condylar hyperplasia; condylectomy; facial asymmetry.

Figure 1

Condyle characteristics in cone beam CT used to determine the need for study with SPECT. Decrease in cortical size in the upper sector of the condyle is observed in coronal cut.

Figure 2

Characteristics of facial bones related to the greater condylar volume observed in cone beam CT. Facial asymmetry is evaluated with chin, dental and nasal position.