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.

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.

Salivary duct cyst of accessory parotid gland in contact with the temporomandibular joint

A 60-year-old woman presented with a painless swelling in the right preauricular region. Physical examination revealed a soft, nontender, oval-shaped lump in this location. Computed tomography indicated an anterolateral cystic lesion that was attached to the condyle of the mandible and to the accessory parotid gland. Differential diagnoses included ganglion cyst, synovial cyst of the temporomandibular joint, and accessory parotid gland cyst. Surgical removal of the cyst was performed with the patient under general anesthesia. The specimen was 18 × 20 × 18 mm in size; it contained fluid that was clear, slightly yellow, and amylase positive. Hematoxylin and eosin staining revealed that a bilayer cuboidal epithelium lined the cyst wall. Immunohistochemical analyses of the cyst wall showed strong expression of cytokeratin and weak expression of vimentin. The final diagnosis was a salivary duct cyst. The postoperative course was uneventful except for a transient facial motor paresis.

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.