Asymmetry of glenoid fossa as differential diagnosis for hemimandibular elongation

Abstract

Facial asymmetry is one of the main fi ndings during clinical practice with a prevalence between 21-85%; this causes both functional and aesthetic problems, and is manifested by an inconsistency in size, shape, or position of craniofacial structures on both sides of the mid-sagittal plane. Its etiology is attributed to hereditary and/ or environmental factors that may be expressed during the fetal, childhood and/or pubertal stage, including unilateral condylar hyperactivity, functional disharmony of the masticatory muscles, dominance of one cerebral hemisphere, plagiocephaly, unilateral craniosynostosis, among others. The time of evolution prior to its detection contributes to the level of expression of the asymmetry. By means of a literature review, the proposal of a differential diagram and the presentation of a case report which includes facial analysis, cephalometric analysis, 3D tomographic reconstruction and fi ndings of nuclear medicine, differential diagrams are suggested as well as a new classifi cation of facial asymmetry. The differential diagnosis between asymmetry of the glenoid fossa and hemimandibular elongation is established, which requires a careful correlation of clinical fi ndings and imaging tests, since both have similar clinical characteristics, but differ in their therapeutic approach.