PMC4178358_01
Pre-op. frontal photograph
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F1
On clinical examination there was obvious facial asymmetry with deviation of chin to the contralateral side and associated angulation of labial commissure and lateral tilting of mandibular incisor teeth, which accentuated the nasolabial fold over the unaffected side [Figure 1].
Pre-op. occlusion
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F2
Further, there was slight but conspicuous posterior open bite on the affected side and associated anterior cross bite over the uninvolved side [Figure 2].
Coronal CT scan view showing deformed condylar mass
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F3
Further both coronal as well as transverse sections on CT scan also showed the deformed condyle and medial extension of the bony mass [Figure 3].
PMC4178358_02
PMC4178358_03
Excised specimen
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F4
The right bony mass which consisted of fractured malunited condyle and an extra bony extension [Figure 4], was excised through preauricular approach under general anesthesia.
Post-op. frontal photograph
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F5
After complete excision of the condylar head, temporal fascia was interposed and the desired occlusion was achieved by intermaxillary wire ligation [Figure 5].
Post-op. occlusion
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F6
Results were found satisfactory [Figure 6].
Histopathology of excised specimen
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F7
There was a regular pattern on the surface with no sign of neoplasia or dysplasia [Figure 7].
PMC4178358_04
CASE 2- Pre-op. frontal photograph
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F8
There was deviation of chin toward the left side with flattening of face along with shifting of facial midline and associated malocclusion [Figures 8 and 9].
Pre-op. occlusion
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F9
There was deviation of chin toward the left side with flattening of face along with shifting of facial midline and associated malocclusion [Figures 8 and 9].
PMC4178358_05
Radiograph showing condylar hyperplasia (Right side)
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F10
Towne's view of TMJ there was an obvious elongation of the condylar neck [Figure 10]. This elongation was calculated on the radiograph by measuring the distance from top of the condyle to the line drawn through base of the sigmoid notch on each side and the difference between the two sides was conclusive.
Post-op. frontal photograph
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F11
Results were satisfactory [Figures 11 and 12].
Post-op. occlusion
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F12
Results were satisfactory [Figures 11 and 12].