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A systematic review and meta-analysis of the surgical outcomes in patients with osteochondroma of mandibular condyle

医学 骨软骨瘤 髁突 颞下颌关节 正颌外科 外科 牙关紧闭 保守管理 牙科
作者
Anish Poorna T,Ragavi Alagarsamy,E K Joshna,Ashutosh Kumar Singh,Babu Lal,Ajoy Roychoudhury
出处
期刊:Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology [Elsevier]
卷期号:135 (6): 732-745
标识
DOI:10.1016/j.oooo.2022.09.039
摘要

Many options exist in the diagnosis and management of condylar osteochondroma. The purpose of this study was to provide a congregate information concerning treatment of the osteochondroma involving the mandibular condyle. The search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane database until February 2022. Twenty-seven studies were included for the final review. The review included 439 patients who underwent surgical management for mandibular condylar osteochondroma. The position of osteochondroma was mentioned in 13 studies. Preauricular, retromandibular, endaural, submandibular, transzygomatic, and intraoral approaches were used for approaching the tumor. Surgical techniques included resection, conservative condylectomy, and total condylectomy. Concomitant orthognathic surgery was performed along with tumor resection in 19 studies. In the entire review, the recurrence rate was 0.22% (1/439). The results of the meta-analysis showed that 2 studies reported significant malocclusion events after surgical therapy. Total joint replacement after tumor resection has a higher improvement in maximal mouth opening (8 mm) compared with vertical ramus osteotomy and no reconstruction groups, which have similar improvements (6 mm). The mainstay of treatment of osteochondroma is surgical excision either as condylectomy or conservative condylectomy. Among the various reconstruction modalities, total joint replacement showed better improvement in mouth opening. Adjunct procedures like orthodontic and orthognathic surgery have an important role in holistic management of severe cases. The treating surgeon must choose the surgical procedures in a pragmatic way.
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