Caso 24 - Hiperplasia Condilar


Paciente femenino de 61 años de edad. Se realiza estudio radiográfico por presentar marcada asimetría facial. Como único antecedente de importancia refiere traumatismo mandibular en el lado izquierdo hace 25 años. La asimetría ha sido lenta y progresiva. No hay mayores molestias. El estudio radiográfico muestra un extenso agrandamiento del cóndilo del lado izquierdo, mordida abierta en el mismo lado y deviación mandibular hacia el lado opuesto.



El desarrollo excesivo del cóndilo mandibular no es frecuente, puede asociarse a algún trastorno sistémico. Si es un hallazgo aislado puede deberse a la hiperactividad del cartílago o restos cartilaginosos persistentes. Algunos procesos infecciosos por vecindad como las infecciones del oído, u osteomielitis pueden actuar como factores que estimulen el crecimiento, pudiendo limitarse a un solo lado. Puede afectar a niños como adultos (cuarta década de vida). Su crecimiento puede llevarse a cabo lentamente o con rapidez, incluso, puede seguir creciendo o detenerse de forma espontánea. Clínicamente los pacientes presentan una asimetría facial con desviación de la mandíbula hacia el lado opuesto. Puede observarse una rama ascendente de longitud aumentada, pero sin desviación del mentón Radiográfícamente se observa un agrandamiento generalizado del cóndilo con o sin deformación. con un contorno radiográfico anormal, el grosor de la cortical y el patrón trabecular son normales. El cóndilo se afecta totalmente, pero el cuello condilar puede aumentar de tamaño. Es frecuente verla asociada a un alargamiento de la rama mandibular.

Autor(es): Dr. Hugo Aguayo Olivares

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