A facial asymmetry revealed: Active mandibular condylar hyperplasia

Abstract

Condylar hyperplasia (CH) is a rare condition characterized by excessive growth of the mandibular condyle, leading to facial asymmetry, temporomandibular joint (TMJ) dysfunction, and functional impairments such as chewing and speech difficulties. This report presents a 15-year-old patient with mandibular deviation, limited TMJ mobility, and facial asymmetry. Diagnostic imaging, including CT and planar bone scintigraphy with 99mTc-HMDP, revealed active right condylar hyperplasia, with a 14.29% radiotracer uptake difference, surpassing the 10% threshold for metabolic activity. The patient underwent condylectomy, successfully restoring facial symmetry, masticatory function, and TMJ stability. Early physiotherapy complemented the surgical outcome. This case highlights the importance of combining anatomical and functional imaging modalities for accurate diagnosis and treatment planning. Advanced imaging, such as 3D CT and bone scintigraphy, plays a critical role in confirming condylar hyperplasia activity and guiding surgical decisions. Multidisciplinary management is essential, as timely intervention prevents progression, enhances aesthetics, and improves functionality. Condylectomy remains the treatment of choice for active CH, with orthognathic surgery reserved for severe deformities or malocclusion. Early recognition and comprehensive management of CH are crucial to optimizing patient outcomes and ensuring improved quality of life.

Keywords

• Condylar hyperplasia
• Mandibular asymmetry
• 3D CT
• Bone scintigraphy
• Condylectomy