Mandibular condylar hyperplasia

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Mandibular condylar hyperplasia

Published March 12, 2012 by goshgurl95

Hyperplasia of the Mandibular condyle has been identified to be a rare disorder (maybe this is why I can’t find much info on it ?)  which affects the jaw Ulinaterial (one-sided) and this causes facial asymmetry the same as Hemifacial microsomia does  .The condition causes an abnormal growth within the jaw meaning that like in my case for instance one side of the jaw stops growing too early .It usually appears in people aged between 11 -30 years of age and doesn’t necessarily affect one side over the other any more commonly than it does the other side.This condition causes an over development of the head , neck and mandible being the jaw  which results in quite significant functional as well as aesthetical facial deformities .It is something known as CH which causes the facial deformities  



How Many CH Is There?

There is a wide variety of different forms of CH these can include :

  • CH 1 which is the most common form of CH and causes an acceleration of the growth rate within the mechanisms of the jaw CH 1 is most commonly found in females as it occurs twice more than what it does in a male.Also with CH1 the structure of the jaw bone is relatively normal.This form of CH can occur Bilaterally  meaning one of the jaws will grow quicker than the other which is the most common type .The less common type will be Ulinaterial affecting one side of both of the jaws and causes more of a facial deformity than the Bilateral .Usually the growth of the jaw is increased during puberty and the jaw can also carry on growing until in the early to mid 20’s which is self-limiting but it can and usually does cause facial and jaw deformities.CH1 is more common than what is actually realized.CH1 usually goes misdiagnosed  and unnoticed which is due to a lack of understand of its growth pattern
  • CH2 usually occurs in the form of Ulinaterial and features an enlargement of  the head of the condyle .The neck of the condyle increases in thickness and height of the condyle’s ramus  it also features the downwards growth of the ipsilateral maxilla this form of Hyperplasia of the mandibular condyle/mandibular Condylar Hyperplasia can happen at any age ,however this form of Hyperplasia is not-self limiting .This form can be caused by other conditions such as osteochondrama, osteoma or also other types of condyle enlargements which can include things such as benign , malignant tumors of the mandibular condyle , hemifacial hypertrophy
What is the growth pattern of the mandible like ?
The growth patterns of the condyle(s) can have a huge impact on the actual timing of treatments .This is due to the asymmetrical difference of the growth of the condyle as it can develop a slow growth if it is Ulinaterial .A normal condyle should in average be around 15-20mm and 8-10mm wide .But however the condyle in most cases will retain its structure and the length of the head and neck will remain increased .
How do you know if there is active growth ?
Your maxilliofacial team will be able to identify whether there is an active growth within the condyle by a worsening of the function as well as the aesthetical changes which you may also notice.They may also conduct scans of the jaw bone such as x-rays to refer back to older scans and then look at the latest scan to see if there is any increased growth that was not present before.However it is not always possible to detect if there is an active growth in the jaw this can be due to the fact that it tends to work better when scanning a patient who is Ulinaterial affected.It can also be recommended best not to scan those who have CH1 as it is believed that the scans are not always diagnostic enough as would be required or liked .In younger patients the scans can sometimes come back inconclusive
what types of Treatments are available ?
There are a number of treatments available which include your ordinary orthodontics and orthognathic surgery this would usually be performed for those whose condyle have stopped growing and have now become stable .With the CH1 the main aim is to align the teeth and jaw .However with CH2 this is not possible due to the extensive growth of the jaw however there is still treatment available for Ch2 this includes three surgical options .The first option is to try to stop any further growth of the jaw using a condylectomy which removed between 3-5mm off of the condyle head and requires extensive orthognthatic (jaw) surgery to help correct the jaws deformity this option is usually done in either 1 or 2 operations depending on the hospital and surgeon .Option 2 is corrective surgery of the jaw which will not be done until the jaw has stopped growing so this can result in the operation being delayed until in the 20’s a result of this is that there could be a worsening of the noticeable deformity ,worsened speech .Option 3 is  Orthognathic surgery to correct the jaw .This is most commonly preformed during active growth of CH1 after the operation the mandible will continue in its growth and will  require the operation to be repeated

What is associated with Mandibular Condylar Hyperplasia ?

There are a few other conditions and medical issues which can be related to Mandibular Condylar Hyperplasia these include :

  • Rheumatoid arthritis
  • hormonal alterations