A CONSERVATIVE SURGICAL APPROACH TO OSTEOCHONDROMA OF THE TEMPOROMANDIBULAR JOINT

Osteochondroma is an exophytic lesion that arises from the bone cortex and is capped with cartilage.  Although osteochondromas are rare in the craniofacial area, the most affected areas are commonly coronoid process and condyle.  The surgical treatment for an OC of the mandibular condyle has normally either been condylectomy or local excision with or without reconstruction.  This paper describes a case of osteochondroma of the mandibular condyle in a         48-year-old woman who was referred with facial asymmetry, deviation of chin, cross-bite to the contralateral side and malocclusion.  Panoramic radiographs and computerized tomographic scans of the patient confirmed the presence of a bony expansion of the left condyle. Based on clinical and radiographic evaluations, the clinical diagnosis was made as osteochondroma. High condylectomy procedure was planned for reshaping condylar head without additional reconstructive surgery. Condylectomy was performed using a preauricular approach with total removal of the lesion under general anesthesia. The healing was uneventful, and the patient was satisfied with appearance and occlusion in two years. Keywords :  Osteochondroma; Temporomandibular Joint; Mandibular Condyle  TEMPOROMANDIBULAR EKLEMIN OSTEOKONDROMASINA KONSERVATIF CERRAHI YAKLAŞIM Oz Osteokondrom, kemik korteksinden  buyuyen ve kartilajla kapli ekzofitik bir lezyondur.  Kraniofasial bolgede nadir gorulmesine ragmen en cok etkilenen alanlar koronoid proses ve kondildir.  Mandibular kondilde gorulen osteokondromlarin cerrahi tedavisi lezyonun   rekonstruksiyonla  birlikte veya rekonstruksiyon yapilmadan kondilektomi veya lokal eksizyonudur. Bu  raporda  yuzde asimetri,  cene ucu deviasyonu,  karsi tarafta dislerin  capraz kapanisi  ve  malokluzyona neden olmus osteokondrom   belirtileriyle basvuran 48 yasindaki kadin hastanin tedavisi ve 2 yillik takip sonuclari bildirilmektedir. Alinan  panoramik  radyografi ve  bilgisayarli  tomografi goruntuleriyle sol kondildeki kemik ekspansiyonu dogrulandi.  Klinik ve radyografik  degerlendirmelere dayanarak  klinik tani osteokondrom olarak belirlendi.  Ilave   rekonstruktif cerrahi olmaksizin kondil basinin yeniden sekillendirilmesi  icin yuksek seviyeli kondilektomi  planlandi. Genel anestezi altinda  preaurikular yaklasimla  lezyon butunuyle cikarilarak kondilektomi yapildi.  Sorunsuz  iyilesme gozlenirken 2 yil sonunda hastanin mevcut okluzyon ve gorunumden memnun oldugu  goruldu. Anahtar Kelimeler :  Osteokondrom; temporomandibuler eklem; mandibular kondil