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Gupta N, Rubina, Rahman A, Aftab M, Khan R. Giant Cell Tumor of the Temporal Bone with Direct Invasion into the Middle Ear and Skull Base: A Case Report. Indian J Otolaryngol Head Neck Surg 2024; 76:2890-2894. [PMID: 38883509 PMCID: PMC11169301 DOI: 10.1007/s12070-024-04550-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 02/04/2024] [Indexed: 06/18/2024] Open
Abstract
Giant cell tumor (GCT) of bone is a rare, benign, osteolytic neoplasm that most commonly occurs in early adulthood and often involves the long bones of the body. Although GCT largely affects the epiphyses of long bones, several reports of GCT involvement of the cranial and facial bones exist in the literature. In addition to reviewing other reported cases of GCT of the lateral skull base in the literature, the authors report here on the clinical presentation, radiographic findings, and management of a patient found to have a GCT of the squamous part of temporal bone invading the middle ear and infratemporal fossae, which was treated by en bloc resection of the lateral skull base.
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Affiliation(s)
- Nainsi Gupta
- Department of Otorhinolaryngology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
| | - Rubina
- Department of Otorhinolaryngology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
| | - Abdur Rahman
- Department of Otorhinolaryngology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
| | - Mohammad Aftab
- Department of Otorhinolaryngology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
| | - Roobina Khan
- Department of Otorhinolaryngology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh 202002 India
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Raccampo L, Sembronio S, Tel A, Robiony M. Extended Complex Temporomandibular Joint Reconstructions Exploiting Virtual Surgical Planning, Navigation Assistance, and Custom-Made Prosthesis: A Comprehensive Protocol and Workflow. J Pers Med 2023; 13:931. [PMID: 37373920 DOI: 10.3390/jpm13060931] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Alloplastic temporomandibular joint (TMJ) replacement is a well-established procedure in maxillo-facial surgery. However, the surgical management of large excision in this area requires complex reconstruction beyond the standard TMJ prosthesis. OBJECTIVE This study aims to describe the design and the consequential application of a protocol which involves the use of computer-assisted surgery tools to best face complex TMJ reconstruction (TMJR). Preoperative accurate study of every single case and intraoperative check of the surgical act are nowadays essential to perform such delicate surgical procedures. MATERIALS AND METHODS The study is a retrospective and single institution case series. The various processes of the management and planning of extended TMJ reconstruction (eTMJR) are extensively described, from the preoperative clinical evaluation, imaging acquisition protocols and virtual surgical planning (VSP), focusing also on the intraoperative transfer of VSP using navigation and surgical guides. RESULTS We included nine patients with different pathologies which were candidates for eTMJR. Overall, the application of our protocol and workflow permitted the reduction of complications and pain, and the improvement of the maximum interincisal opening (MIO) of the patients, restoring patients' masticatory function and esthetics. CONCLUSIONS The eTMJR should be considered as a safe and reliable surgical management modality in selected patients with large temporomandibular joint and skull base (TMJ-SB) lesions. An accurate preoperative protocol and workflow is essential to perform such insidious and complex reconstruction. However, more extensive studies on this type of device have to be conducted in order to validate its real usefulness and indications.
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Affiliation(s)
- Luca Raccampo
- Maxillofacial Surgery Department, Academic Hospital of Udine, 33100 Udine, Italy
| | - Salvatore Sembronio
- Maxillofacial Surgery Department, Academic Hospital of Udine, 33100 Udine, Italy
| | - Alessandro Tel
- Maxillofacial Surgery Department, Academic Hospital of Udine, 33100 Udine, Italy
| | - Massimo Robiony
- Maxillofacial Surgery Department, Academic Hospital of Udine, 33100 Udine, Italy
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Hu S, Cheng S, Wu Y, Wang Y, Li X, Zheng J, Li J, Peng L, Yang J. A Large Cavernous Sinus Giant Cell Tumor Invading Clivus and Sphenoid Sinus Masquerading as Meningioma: A Case Report and Literature Review. Front Surg 2022; 9:861739. [PMID: 35402500 PMCID: PMC8991686 DOI: 10.3389/fsurg.2022.861739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 12/01/2022] Open
Abstract
Giant cell tumor (GCT) of the bone is a rare benign, locally aggressive tumor that occurs in the epiphysis of long bones, especially the lower femur and the upper tibia. GCT of the bone of cranial origin is very rare, accounting for 1% of all GCT of the bone. We report the diagnosis, treatment, and immunohistochemistry of a rare case of intracranial GCT of the bone. We also review and summarize the imaging features, diagnostic markers, and current major treatment options for GCT of the bone. Our case and literature review emphasizes the importance of considering the full picture when making a diagnosis, rather than relying on imaging alone to make the diagnosis.
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Affiliation(s)
- Shasha Hu
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Shaowen Cheng
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.,Department of Wound Repair, First Affiliated Hospital of Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma Ministry of Education, Hainan Medical University, Haikou, China
| | - Yu Wu
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yanyan Wang
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - XinNian Li
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Jiaxuan Zheng
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Jiao Li
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Lei Peng
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma Ministry of Education, Hainan Medical University, Haikou, China
| | - Jian Yang
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.,Department of Wound Repair, First Affiliated Hospital of Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma Ministry of Education, Hainan Medical University, Haikou, China
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4
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Alani B, Aldoori M, Alaqeeli AA, Farag I. Giant cell tumour of the infra temporal fossa treated with denosumab in an elderly patient: A case reports. ORAL AND MAXILLOFACIAL SURGERY CASES 2022. [DOI: 10.1016/j.omsc.2022.100247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yaprak Bayrak B, Özcan E, Vural Ç, Emengen A, Çabuk B, Ceylan S. A single-center experience with giant cell tumors of sphenoid bone and clivus. TUMORI JOURNAL 2021; 107:NP94-NP100. [PMID: 34374310 DOI: 10.1177/03008916211024357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To present pathologic, clinical, and treatment findings for giant cell tumors (GCTs) of sphenoid bone and clivus. METHODS We describe the optimal treatment algorithm in patients with a histopathologic diagnosis of bone GCT by presenting the effects of denosumab treatment in both pediatric and adult patients with GCT undergoing endoscopic transnasal surgery. Clinicopathologic correlation is crucial for the differential diagnosis of GCT and the choice of treatment modality. CONCLUSION GCT of bone is a local aggressive tumor that accounts for about 3%-7% of all bone tumors. GCTs located in the cranium are extremely uncommon neoplasms. There are no defined guidelines for the treatment of GCTs in skull base. Following surgical resection of the tumor, the addition of denosumab treatments to radiotherapy has a significant role in preventing the recurrence of GCT and in promoting regression of residual tumor size.
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Affiliation(s)
- Büşra Yaprak Bayrak
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Emre Özcan
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Çiğdem Vural
- Department of Pathology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Atakan Emengen
- Department of Neurosurgery, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Burak Çabuk
- Department of Neurosurgery, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Savaş Ceylan
- Department of Neurosurgery, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
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Kadipasaoglu C, Wahba A, Bhattacharjee MB, Cuglievan B, Fletcher SA. Hemorrhagic Giant Cell Tumor of the Occipital Skull Base: A Case Report and Literature Review. Cureus 2021; 13:e13832. [PMID: 33859893 PMCID: PMC8038930 DOI: 10.7759/cureus.13832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Giant cell tumor of bone is a benign but locally aggressive osteolytic neoplasm that represents 3% to 5% of all primary bone tumors, primarily found at the epiphyses of long bones. Less than 1% are of calvarial origin. Herein, we report a rare case of a nine-year-old girl with a hemorrhagic giant cell tumor of the left occipital skull base.
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Affiliation(s)
- Cihan Kadipasaoglu
- Department of Pediatric Surgery, Division of Pediatric Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, USA
| | - Andrew Wahba
- Division of Pediatrics and Patient Care, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Meenakshi B Bhattacharjee
- Department of Neuropathology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, USA
| | - Branko Cuglievan
- Division of Pediatrics and Patient Care, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Stephen A Fletcher
- Department of Pediatric Surgery, Division of Pediatric Neurosurgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, USA
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Yibulayin F, Yu CX, Feng L, Wang M, Lu MM, Luo Y, Liu H, Yang ZC, Wushou A. Malignant tumours of temporomandibular joint. BMC Cancer 2020; 20:967. [PMID: 33023507 PMCID: PMC7539439 DOI: 10.1186/s12885-020-07425-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/16/2020] [Indexed: 01/27/2023] Open
Abstract
Background Malignant tumours of the temporomandibular joint (MTTMJ) are extremely rare. Studies describing its unique epidemiology, clinicopathological features, treatment and prognosis comprehensively are limited. To address these issues, current investigation was performed. Methods A retrospective research was carried out by using population-based data from the Surveillance, Epidemiology, and End Results database (1973–2016). Results Data for a total of 734 patients, including 376 men and 358 women, was found. The median age was 47 years. The 5-year and 10-year disease specific survival (DSS) rates were 69.2 and 63.6%, respectively. Significant differences in DSS were found according to age, race, tumour type, AJCC/TNM stage, surgery, radiotherapy, chemotherapy and different treatment modalities (P < 0.05). In the multivariate survival analysis, age > 44 years and AJCC stage III and IV were associated with poor DSS. Conclusion MTTMJ was mostly found in white people with a median age of 47 years without any sex predominance. Patient’s age and AJCC stage was independent predictor of DSS.
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Affiliation(s)
- Feiluore Yibulayin
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China.,Department of Preventive Medicine, School of Public Health, Shanghai Medical College, Fudan University, Shanghai, 200001, People's Republic of China
| | - Chen-Xi Yu
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China.,Department of Clinical Medicine, Shanghai Medical College, Fudan University, Shanghai, 200001, People's Republic of China
| | - Lei Feng
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China
| | - Meng Wang
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China
| | - Meng-Meng Lu
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China
| | - Yuan Luo
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China
| | - Hui Liu
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China
| | - Zhi-Cheng Yang
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China.
| | - Alimujiang Wushou
- Department of Oral & Maxillofacial Surgery and Oral Biomedical Engineering Laboratory Shanghai Stomatological Hospital Fudan University, 356 Beijing East Road, Shanghai, 200001, People's Republic of China.
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Customized skull base–temporomandibular joint combined prosthesis with 3D-printing fabrication for craniomaxillofacial reconstruction: a preliminary study. Int J Oral Maxillofac Surg 2019; 48:1440-1447. [DOI: 10.1016/j.ijom.2019.02.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 01/04/2019] [Accepted: 02/27/2019] [Indexed: 12/18/2022]
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Abstract
The aim of the study is to discuss the current management options for intra- and extra-cranial communication giant cell tumor of the lateral skull base and perform a review of the literature. A total of 6 patients with giant cell tumor of the lateral skull base were retrospectively enrolled in the study. The principal complaints, imaging manifestations, surgical resection and reconstruction of intra- and extra-cranial communication defects for the diseases were discussed. There were 2 males and 4 females. The most of principal complaints were discomfort or pain in the temporomandibular joint in 5 cases (83.3%). Imaging examination showed invasion of the temporal bone alone in 3 cases (50.0%) and both temporal bone and sphenoid bone involvement in 3 cases (50.0%). C-shaped preauricular infratemporal fossa approach was used for tumour removal and gross total resection was done in all 6 cases. The pedicled temporal muscle fascial flap was used to reconstruct the intra- and extra-cranial communication defect of the lateral skull base. The conclusion is that giant cell tumor is a benign tumor but is also locally aggressive. Gross total resection is the most commonly recommended treatment choice for giant cell tumor of the skull and can achieve good treatment outcomes. The temporalis muscle flap is a good alternative choice for reconstruction of the defect.
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Updated Review of Traumatic Dislocation of the Mandibular Condyle Into the Middle Cranial Fossa. J Oral Maxillofac Surg 2019; 77:132.e1-132.e16. [DOI: 10.1016/j.joms.2018.09.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 12/19/2022]
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Gamboa NT, Ronna B, Gamboa CT, Palmer CA, Park MS, Gurgel RK, Couldwell WT, Kalani MYS. Giant Cell Tumor of the Lateral Skull Base: Diagnostic and Management Options. J Neurol Surg Rep 2018; 79:e41-e54. [PMID: 29845001 PMCID: PMC5969995 DOI: 10.1055/s-0038-1645885] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 02/27/2018] [Indexed: 01/02/2023] Open
Abstract
Giant cell tumor of bone (GCTB) is a rare, benign, osteolytic neoplasm that most commonly occurs in early adulthood and often involves the long bones of the body. Although GCTB largely affects the epiphyses of long bones, several reports of GCTB involvement of the cranial and facial bones exist in the literature. In addition to reviewing other reported cases of GCTBs of the lateral skull base in the literature, the authors report here on the clinical presentation, radiographic findings, and neurosurgical management of a patient found to have a GCTB of the middle and infratemporal fossae, which was treated by aggressive en bloc resection of the lateral skull base.
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Affiliation(s)
- Nicholas T Gamboa
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Brenden Ronna
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Christina T Gamboa
- Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Cheryl A Palmer
- Division of Anatomic Pathology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Min S Park
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - Richard K Gurgel
- Division of Otolaryngology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - William T Couldwell
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
| | - M Yashar S Kalani
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
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Chen MJ, Yang C, Zheng JS, Bai G, Han ZX, Wang YW. Skull Base Erosion Resulting From Primary Tumors of the Temporomandibular Joint and Skull Base Region: Our Classification and Reconstruction Experience. J Oral Maxillofac Surg 2018; 76:1345-1354. [PMID: 29406260 DOI: 10.1016/j.joms.2017.11.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/03/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE We sought to introduce our classification and reconstruction protocol for skull base erosions in the temporomandibular joint and skull base region. PATIENTS AND METHODS Patients with neoplasms in the temporomandibular joint and skull base region treated from January 2006 to March 2017 were reviewed. Skull base erosion was classified into 3 types according to the size of the defect. RESULTS We included 33 patients, of whom 5 (15.2%) had type I defects (including 3 in whom free fat grafts were placed and 2 in whom deep temporal fascial fat flaps were placed). There were 8 patients (24.2%) with type II defects, all of whom received deep temporal fascial fat flaps. A total of 20 patients (60.6%) had type III defects, including 17 in whom autogenous bone grafts were placed, 1 in whom titanium mesh was placed, and 2 who received total alloplastic joints. The mean follow-up period was 50 months. All of the patients exhibited stable occlusion and good facial symmetry. No recurrence was noted. CONCLUSIONS Our classification and reconstruction principles allowed reliable morpho-functional skull base reconstruction.
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Affiliation(s)
- Min-Jie Chen
- Professor, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; and National Clinical Research Center of Stomatology, Shanghai, China
| | - Chi Yang
- Professor, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; and National Clinical Research Center of Stomatology, Shanghai, China.
| | - Ji-Si Zheng
- Resident, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; and National Clinical Research Center of Stomatology, Shanghai, China
| | - Guo Bai
- Resident, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; and National Clinical Research Center of Stomatology, Shanghai, China
| | - Zi-Xiang Han
- Resident, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; and National Clinical Research Center of Stomatology, Shanghai, China
| | - Yi-Wen Wang
- Resident, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; and National Clinical Research Center of Stomatology, Shanghai, China
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Benign Temporomandibular Joint Lesions Presenting as Masses in the External Auditory Canal. Otol Neurotol 2017; 38:563-571. [PMID: 28288478 DOI: 10.1097/mao.0000000000001354] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Describe benign lesions arising from the temporomandibular joint (TMJ) that presented as masses in the external auditory canal (EAC). STUDY DESIGN Retrospective case series of two academic medical centers. PATIENTS Six patients with lesions emanating from the TMJ that presented as EAC masses. Lesions included pigmented villonodular synovitis (PVNS), nodular fasciitis, foramen of Huschke herniation with salivary fistula, fibroepithelial polyp, superficial angiomyxoma, and giant cell tumor (GCT). INTERVENTION Surgical resection. MAIN OUTCOME MEASURES Tumor control, TMJ function, and hearing. RESULTS All patients presented with hearing loss, TMJ pain, and otalgia. Three patients with EAC occluding masses developed entrapment cholesteatoma between the mass and tympanic membrane. Following surgical resection, four patients were free of disease. The patient with PVNS has a stable remnant at 3 years follow up and the patient with giant cell tumor is under active surveillance. Hearing improved in three patients, remained stable in one patient, and worsened in two patients. All had resolution of their TMJ and ear pain. CONCLUSIONS EAC masses of uncertain origin should be imaged preoperatively to exclude lesions best not biopsied (e.g., encephalocele, facial nerve schwannoma, paraganglioma). In the differential of EAC masses, lesions emanating from the TMJ need to be considered, especially for those based anteriorly. Understanding the extent of TMJ involvement is crucial for surgical planning which optimizes outcome. Goals for therapy are to control the underlying disease process, restore patency of the EAC, improve hearing, and preserve function of TMJ.
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