# Unilateral Condylar Hyperplasia in Surgeons' Perspective--A Narrative Review
## 7 Treatment from Surgeons' Perspective
### Condylectomy
The use of orthodontic treatment is suitable for some small or mild cases of overgrowth. The problem remains crucial when there are differences in the ramus vertical height and maxillary asymmetry with their own growth on the affected side of UCH [83; 84; 85]. 2. Low condylectomy: dedicated to removing a larger volume of MCH with just the far inferior part left alone. On the other hand, [PERSON] et al. 's study on 37 UCH-2 (osteochondoma of mandibular condylectomy associated with mandibular deformity) patients used a low condylectomy approach in all patients with recontouring of the condylar neck to form a new condyle, repositioning of the articular disc over the condylar stump, and repositioning of the contralateral disc if any symptoms of displacement or malposition might occur, and any indicated orthognathic surgical procedures [6; 75; 86]. Further, follow-ups concluded that low condylectomy and orthognathic surgery improved not only TMJ function and proper joint movements but reduced any pain or other related symptoms [87; 88; 29; 89]. 3. A total condylectomy procedure (TCP) is rarely used in UCH and is mostly dedicated to condyle tumors, such as osteochondomas (OC). [PERSON] et al., after total condylectomy for condyle repair, used a costochondral graft and preserved the articular disc with good outcomes. Some authors advise leaving the resected condyle in the joint without reconstruction or suturing with pterygoid muscles only or using other modifications [13; 90; 91]. The neocondyle condyle might be unstable for quite some time, and patient education on chewing, biting, diet, and other factors is necessary. 4. Proportional condylectomy is a special technique that compares the head and rmus's vertical and horizontal diameters to ensure a more balanced result after the procedure, and therefore this amount of condyle is excised. [PERSON] et al. 's retrospective study on 73 patients with UCH was divided into vertical (61.6%) and transversal (38.4%) forms of UCH according to [PERSON]'s classification [92]. Using proportional condylectomy in the authors' approach, followed by indicated orthognathic techniques, maxilla-mandibular elastic therapy, and rehabilitation, is a good, accurate, and reliable option for treating UCH, regardless of the activity status of the pathology [93]. 5. Condylar head reshaving and modeling with bone drills, chisels, and piezosurgery (the most superior part of the MCH) [94]. 6. Transoral approach. This might include techniques with mandibular coronoid process osteotomy to gain more visibility toward the condyle, as reported by [PERSON] et al. [95]. A similar approach to the intraoral approach was described by [PERSON] et al., which might be combined with coronoid process resection and an IVRO procedure-intraoral vertical ramus osteotomy [96; 97]. Approaches with computer-guided/3D navigation techniques can also be useful. The intraoral approach for a condylectomy is challenging and can be used in various technique alternations. Some authors combine it with a coronoidectomy, while others combine it with temporal coronoid process osteosynthesis to improve access to the MC. The presented method by [PERSON] et al. described new insights into accurate and safe intraoral approaches [98]. The endoscopic-assisted transoral approach is a similar approach and technique used for intraoral condyle fracture osteosynthesis after fractures and can also be used with a great deal of success to improve intraoral condylectomy [99; 100; 101]. 7. Three-dimensional-guided and similar planning guides: [PERSON] et al. introduced the usage of 3D mandible and skull cast models based on CBCT to establish the best methods of surgical planning on 3D printed models [102]. The herein-mentioned planning on two cases indicates that proportional condylectomy might be used as the sole procedure for UCH treatment when detailed measurements on 3D models, either virtual or printed, are used to improve the surgical outcomes [103; 104]. 8.