片側性下顎頭過形成による顔面非対称に対してオトガイ形成術および下顎下縁切除術を行った1例

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  • A Case of Facial Asymmetry Caused by Unilateral Condylar Hyperplasia Treated by Genioplasty and Resection of the Mandibular Inferior Marginal Bone

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Facial asymmetry caused by unilateral condylar hyperplasia has been generally treated by condylectomy and/or orthognathic surgery. Here we report a case of unilateral condylar hyperplasia treated by resection of the mandibular inferior border with genioplasty for correction of facial asymmetry. A 54-year-old woman was referred to our hospital to treat asymmetry of her lower face. She had an asymmetric mandible with mental deviation resulting from hyperplastic condyle, and elongated ramus. She had Angle Class I occlusion with horizontally inclined occlusal plane. Preoperative posterior-anterior cephalogram showed hyperplasia of the left condyle and its neck with deviation of Menton (Me) to the right. Because she did not expect a change of her current occlusal condition, orthognathic surgery by bimaxillary osteotomy combined with condylectomy was refused. Alternatively, intraoral surgical resection of the mandibular inferior marginal bone and genioplasty was planned. To avoid inferior alveolar nerve injury, marginal resection of the inferior mandibular bone was limited below the mandibular canal and bone was cut by using a piezoelectric device. Although the amount of resected bone of the mandibular inferior marginal bone was restricted, she has been satisfied with her postoperative facial appearance.

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