[True trigeminal neuralgia. Increased cholesterol and triglycerides in blood as an etiologic factor?].
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Biomedical subjects
Publications and source records attributed to R Wang-Norderud.
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The etiology of unilateral condylar hyperplasia is obscure. We believe that it is due more likely to an intra-uterine influence rather than to genetic disturbances. The disorder appears to have its basis in the cartilagenous growth centre of the mandibular condyle. The clinical picture varies a great deal, depending upon the onset of the growth upset relative to the age of the patient and the rate of growth. Two cases are reported. In one patient the anomalous growth pattern was apparent particularly in the condylar neck, which showed marked elongation, thickening and angulation. In the other patient the entire condyloid process appeared proportionately enlarged. The typical clinical history is one in which the patient had been aware for many years of progressive deviation of the jaw. Pain in the T.M.J. regions is rarely the presenting symptom. With recent advances of oral surgery, restoration of malocclusion and facial disharmony can be achieved by approaches other than the traditional procedure of condylectomy.
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The incidence of true osteoma in the mandibular condyloid process is extremely rare. An unusual case in a 35-year-old man with a classic picture of facial asymmetry is reported. Because of the microscopic similarity of benign osteogenic neoplasma and the hyperplastic overgrowths, the diagnosis of osteoma is sometimes difficult. We believe that the essential differences between an osteoma and an exostosis lie in the location of the overgrowth, the extent of involvement of the condyle, and the age of the patient. Surgical excision is justified because benign tumors of bone do not invariably retain their innocent characteristics.
Osteochondroma of the mandibular condyle is extremely rare. An unusual case of a 32-year-old man is reported. Throughout a two-year period the patient suffered from intractable pain in the left T. M. J. region, anterior dislocation of the condylar head, malocclusion and facial asymmetry. Radiologic examination revealed that the cartilaginous cap of an overgrowth had functioned as an articular cartilage. A "pseudo articulation" was created with the prominent articular eminence and allowed an almost free movement of the mandible. Review of the seven reported cases revealed that the rare occurrence, natural history, clinical course and lack of recurrence of osteochondroma of the condylar process all substantiate the contention that this overgrowth must be considered as an osteocartilaginous exostosis rather than a neoplasm.