Ganglion cyst of the temporomandibular joint

Ganglion cyst of temporomandibular joint - A systematic review

Ganglion cyst of the temporomandibular joint (TMJ) is an uncommon pathology with uncertain etiology. There is no consensus on their management. The current systematic review aimed to discuss the clinical and histopathological features of ganglion cysts of TMJ, to aid in appropriate treatment. A literature search was done and a total of 20 cases were retrieved from published databases such as PubMed, SCOPUS, and Google Scholar. The cyst presented with swelling in all the cases followed by pain (50 %) and trismus (35 %) as other common symptoms. Though CT and MRI proved helpful in determining the location of the cyst, a histopathological examination was essential in concluding its final diagnosis. It is a pseudocyst lined by dense fibro-connective tissue with myxoid tissue degeneration. Histologically, it is essential to distinguish them from the clinically and radiographically similar true cyst of TMJ, synovial cyst. The lining of ganglion cyst is devoid of epithelium and synovial cells. Surgical excision was found to be the treatment of choice with minimal recurrence (10 %) being reported.

Synovial Cysts in the Temporomandibular Joint: a Case Report and Critical Review of the Literature

Background

Synovial cysts of the temporomandibular joint are rare and treatment is based on consensus from cases reporting unilateral successful outcomes. A patient with a synovial cyst is presented, treated with successful surgical excision of the cyst, but without remission of joint symptoms. Furthermore, the case is supplemented by a critical, literature review.

Methods

This case report deals with a patient with a synovial cyst that presented with temporomandibular joint (TMJ) pain and reduced mouth opening. Magnetic resonance imaging verified a TMJ cyst.

Results

Surgical excision removed the synovial cyst, and the patient was followed-up for 4 years, with no recurrence of the cyst. Despite successful excision of the cyst, the symptoms did not subside, and the patient is still in treatment. The critical, literature review found 23 case reports describing 24 synovial cysts. In addition, 4 cases were included as their synovial cysts were erroneously described as ganglion cysts. In 4 cases, histological diagnosis could not be confirmed, and they were excluded. All cases described treatment by surgical excision without recurrence. The reported median follow-up was 10 months and postoperative TMJ symptoms were rarely examined or described.

Conclusions

The temporomandibular joint symptoms may persist despite successful removal of the synovial cyst. Furthermore, the 4 identified synovial cysts, mislabelled as ganglion cysts, represents almost a quarter of the cases of the reported synovial cysts. Correct labelling and reporting of synovial cysts are still imperative to describe the diverse aspects of treatment outcomes following surgical excision.

Ganglion Cyst of the Temporomandibular Joint Mimicking Auriculotemporal Neuralgia

Ganglion cysts within the temporomandibular joint (TMJ), although uncommon, typically present with swelling, pain, trismus, and difficulty with mastication. The authors report an unusual case of a ganglion cyst in the TMJ of a 52-year-old man who presented with chief complaints of severe headaches and dizziness that had not subsided following treatment with medication, trigger point injections, or sphenopalatine ganglion blocks. The cyst appeared as a nonenhancing, T2 hyperdensity adjacent to the left TMJ condyle on magnetic resonance imaging, supported by the presence of chronic erosion and remodeling of the anterior aspect of the left condylar head on computed tomography. The cyst was surgically removed, and the patient reported that the migraines and accompanying dizziness had ceased 6 months postoperatively. The patient's presentation and improvement following surgery suggest that the location of the cyst in the TMJ and its proximity to the course of the auriculotemporal nerve may have caused auriculotemporal neuralgia, mimicking the symptoms of migraine.

Ganglion cyst in the temporomandibular joint: A case report and discussion of surgical approaches

Background: Ganglion cysts in the temporomandibular joint are treated by resection; however, there has been insufficient discussion regarding the appropriate approach for surgical resection. Clinical presentation: A 55-year-old man presented with a left preauricular swelling for one year. The examination revealed a moderately hard mass with a 30-mm diameter, tenderness, and restricted movement. Magnetic resonance imaging showed a cystic lesion with a 25 mm-long axis. Considering a diagnosis of temporomandibular cyst, separation of the cyst wall through a preauricular incision was attempted. However, the cyst ruptured due to strong adherence on the reverse side. Curettage followed by discectomy was performed. Histopathological diagnosis was of a ganglion cyst. Among 39 reported cases, 24 were excised via the preauricular approach, with 8 intraoperative cyst ruptures. Conclusion: The parotidectomy approach should be employed when the cyst is large, at a low position, or adherent to the surrounding tissue, in order to achieve reliable excision.

Ganglion and Synovial Cyst of the Temporomandibular Joint: A Case Report and Literature Review

Ganglion and synovial cysts of the temporomandibular joint (TMJ) are rare. Although histopathological findings differ, clinical presentation is comparable. This study adds a case report of a ganglion of the TMJ to existing literature and a review of all available case reports on ganglion and synovial cysts of the TMJ. Including our own case report, we reviewed 49 cases of ganglion and synovial cysts of the TMJ. They occurred in a female:male ratio of 3:1, at an median age of 46 years (range, 11-64 years). Patients mainly presented with preauricular swelling and pain. After imaging, the ganglion or synovial cyst was most commonly excised under general anesthesia. No recurrences were described.

Ganglion cyst of the temporomandibular joint

INTRODUCTION

Ganglion cyst of the temporomandibular joint is a rare disease, which may arise from myxoid degeneration of the collagenous tissue of the temporomandibular joint capsule, without epithelial or endothelial lining. We report a case of cystic lesion in a 40-year-old female patient.

OBSERVATION

The patient had a left pre-auricular oval-shaped swelling without any articular symptoms. The pathological analysis after surgical removal allowed diagnosing the lesion as a ganglion cyst of the left temporomandibular joint.

DISCUSSION

We made a literature review and noted that this condition was predominant in female patients. We recommend using MRI for diagnostic purposes and surgery as the best therapeutic alternative.

Ganglion cyst of the temporomandibular joint with intracranial extension in a patient presenting with seventh cranial nerve palsy

Ganglion cysts arising from the temporomandibular joint are rare entities that often present with swelling and minimal to no pain in the preauricular region. To the authors' knowledge, a temporomandibular joint ganglion cyst occurring with acute facial nerve palsy and intracranial extension has never been reported. The patient in the current case initially underwent treatment for Bell palsy and then draining of the cyst at an outside hospital with no relief of symptoms. Repeat MR imaging showed an increase in the size of the cystic, enhancing, middle fossa lesion measuring 4 cm. Resection of the lesion was undertaken using a middle fossa approach. After a satisfactory surgical decompression, the patient demonstrated a significant recovery in her facial palsy over a 3-month period of time. This case presents new clinical and radiographic findings associated with these lesions.