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Journal Information
Vol. 68. Issue 5.
Pages 303-304 (September - October 2017)
Vol. 68. Issue 5.
Pages 303-304 (September - October 2017)
Images in Otorhinolaryngology
DOI: 10.1016/j.otoeng.2017.08.003
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Bilateral Bifid Mandibular Condyle
Cóndilo mandibular bífido bilateral
Carlos Prola,
Corresponding author

Corresponding author.
, Julio Álvareza, Josu Mendiolab
a Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario Gurutzeta/Cruces, Barakaldo, Vizcaya, Spain
b Servicio de Radiodiagnóstico, Hospital Universitario Gurutzeta/Cruces, Barakaldo, Vizcaya, Spain
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A female aged 13 with a background of tension headaches consulted due to a cracking sound in her left temporo-mandibular joint (TMA). She stated she had had no previous trauma, parafunctional habits or blockages. Examination revealed pain on palpation of the masticatory muscles, not in the TMA, maximum oral aperture (MOA) of 55mm, protusive movements, normal separation and Angle class I occlusion. A panoramic radiograph was requested (Fig. 1) which revealed the right condylar surface of anomalous morphology and the left TMA with no changes. An MRI scan was performed (Fig. 2) showing irregular flattening of both condyles, correct positioning of disks in occlusion and MOA, and slight right articular spillover. Computerised tomography was requested (CT) (Fig. 3) which showed both upper condylar surfaces with a depression, with no other bone changes, which was compatible with middle-lateral bifid condyle. Conservative treatment ensued, with no further changes after 6 months of follow-up.


The incidence of bifid mandibular is 0.48%, most of which are unilateral and the causes of which are contested. In cases with mid-lateral coronal plane disposition, it has been postulated that changes in embryonic development occurred, whilst in antero-posterior cases, trauma aetiology is suggested. Most cases are asymptomatic. TMA pain dysfunction syndrome has been described in association, which may even lead to ankylosis. The optimum diagnostic test is a CT scan. MR imaging is able to evaluate the organic damage and provide a view of disk adaptive morphologies. Treatment tends to be conservative (anti-inflammatory drugs, muscle relaxants, and splint), with open surgery or arthroscopy in cases of TMA with degeneration.

Please cite this article as: Prol C, Álvarez J, Mendiola J. Cóndilo mandibular bífido bilateral. Acta Otorrinolaringol Esp. 2017;68:303–304.

Copyright © 2016. Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello
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