Surgical Treatment of Hemimandibular Hyperplasia Leading to Unilateral Overdevelopment of the Face

Hemimandibular hyperplasia is a facial deformity which may develop in any age and includes a unilateral enlarged mandibular condylar head, deviation of mandible and chins, elongated condylar neck or ramus, and an occlusal cant with open bite. Different surgical treatments are proposed in the literature from simple low or high condylectomy to more complex procedures combining osteotomies in different sites of the mandible. Surgical procedure is defined by the clinical evaluation and scintigraphic diagnosis of activity or inactivity in the center of condylar growth.. This case report describes a 30-year-old female patient with left hemimandibular hyperplasia with activity of condylar growth, that was successfully treated with low condylectomy, asymmetric lefort I osteotomy and inferior border ostectomy on the affected side, and associated with a unilateral sagittal split ramus osteotomy on the contra-lateral side.. The innovation on nerve dissection by removing the overlying buccal bone and performing inferior ostectomy under direct visualization of the nerve, proved to be a safe technique with a low risk of nerve damage..