A case of osteochondroma of the mandibular condyle
Osteochondroma is one of the most common benign bone tumors of axial skeleton but it is rarely seen in maxillofacial region. The following case has been reported in the journal Case reports in dentistry.

A 34-year-old male came with a chief complaints of asymmetry and difficulty in opening and closing of the mouth and mastication approximately for two years.

On clinical examination there was a painless bony, hard swelling on the right preauricular region. The symptoms were restricted inter-incisal range, malocclusion, deviation during mouth opening and prominent facial asymmetry. The overlying skin was in normal color and texture. No evidence of soft tissue involvement was noted. The lesion was fixed to the underlying bone and was non-mobile. Intraoral examination revealed contralateral cross-bite and restricted mandibular movements.

Panoramic radiograph of the patient revealed mandibular asymmetry and a well-defined bone enlargement on the right condylar head with slight radiopacity increase. Slow displacement of mandible results with adaptation of bony structures for compensation. Therefore, compared with the contralateral side increase in height of condylar neck and thickness of mandibular body were observed on panoramic radiography.

For more detailed radiographic examination patient was advised a computed tomography (CT) scan. The axial and coronal CT sections revealed a clearly distinguishable cartilaginous/bony outgrowth arising from the right condylar head and length increase of the condylar neck. The lesion was extending from anteromedial aspect of the condyle into the articular fossa. Patient was referred to maxillofacial surgery department with the provisional diagnosis of osteochondroma.

Lesion was excised under general anesthesia and nasotracheal intubation with pre-auricular incision. Active jaw motion exercises including jaw opening, lateral excursion and protrusion were performed for three weeks. The size of the excised lesion was approximately 1.8x1.6x1.3 cm. The histopathologic examination revealed a nodular lesion with cartilaginous cap and mature bone tissue beneath, confirming the diagnosis of osteochondroma of the mandibular condyle.

After two years follow-up of the patient mouth opening and TMJ functions were in normal limits but slight facial asymmetry and occlusal cant still remained. However, occlusion was in acceptable range. Postoperative panoramic radiography of the patient proved condylar remodeling and a more acceptable appearance in terms of symmetry.

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