Transzygomatic approach for the resection of large condylar osteochondromas using computer-assisted preoperative planning

The purpose of this study was to evaluate the outcomes of patients with large osteochondromas (OCs) treated via transzygomatic approach for exposure and local resection. All patients with large OCs treated by transzygomatic approach from 2006 through 2014 were investigated. The inclusion criteria were (1) condylar OC of exogenous type; (2) a mass that could be treated only via transzygomatic approach, as assessed using computer-assisted preoperative planning. The preliminary results evaluated included recurrence, joint form and function, occurrence of facial deformity, facial nerve function, and the condition of the zygomatic arch fixation. Other parameters assessed included tumour size and location and the length of follow-up. Ten patients with OCs were included in this study. All masses were located anteromedial to the condyle; the average maximal diameter was 33.15 mm. During follow-up (average 28.5 months), the average maximum inter-incisal opening increased from 25.4 mm to 32.0 mm. Nine patients recovered without recurrence, a change in occlusion, secondary deformity, or nerve dysfunction. One patient had severe disc perforation and condylar resorption. The transzygomatic approach is applicable for the resection of large condylar OCs protruding anteromedially into the infratemporal space. Surgical simulations may help to identify the indications for this approach and to design the surgery.