PMC3906655_01
Case 1. 34-year-old male patient presenting with facial asymmetry due to hemimandibular hypertrophy hybrid variant. (a) Photograph of the face shows elongation of mandible on the right. (black arrow). Deviation of chin to the left. (white arrow). (b) X-ray posterio-anterior view of skull shows mandibular enlargement and transverse canting of occlusal plane on the right side (white arrow). (c) Three-dimensional computed tomography shows right sided hemimandibular hypertrophy along with bilateral crossbite. (d) Scintigram demonstrates hot spot (arrow) in the condylar region, indicative of increased activity in the mandible.on the right side. (e) Clinical photograph of the face post-treatment.
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F1
The mandibular body and ramus appeared longer and wider on the right side as compared to the left side [Figure 1a]. Height of the ramus and body of the mandible were also larger along with transverse canting of the occlusal plane on the right side [Figure 1b]. Three-dimensional computed tomography (CT) image showed elongation and enlargement of condyle, ramus, and body of the mandible on the right side [Figure 1c]. Scintigram demonstrated hot spots indicative of increased uptake of radioisotope in the condylar region on the right side [Figure 1d]. Patient was referred to the oral and maxillofacial surgery department, where orthognathic surgery was done and both function and esthetics of the patient's facial structure were restored [Figure 1e].
PMC3906655_02
Case 2. 18-year-old girl with asymmetry of the face due to hemimandibularr hypertrophy hybrid.variant. (a) Photograph of the face shows enlargement of mandible on the right side. (white arrow) with deviation of chin to the left. (black arrow). (b) Intra-oral view reveals open bite. (thick arrow). Mandibular central incisor midline does not coincide with facial midline. (thin arrow). (c) Panoramic radiograph demonstrates elongation (arrow) and increased distance between the mandibular molar roots and inferior alveolar nerve canal on the right side (double-headed arrow). (d) Three-dimensional computed tomography (CT) shows elongation and enlargement of the mandible on the right side (arrow). (e) CT axial view reveals asymmetry due to increased growth of the mandible on the right side (arrow).
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F2
Enlargement of the right side of mandible was clearly seen [Figure 2a]. Open bite was present on the right posterior tooth region [Figure 2b]. The distance between the mandibular roots and the inferior alveolar nerve on the right side was more than that on the left side [Figure 2c]. Further, CT demonstrated elongation and medial rotation of right lower border of the mandible [Figure 2d and e].