TY - JOUR
T1 - Synovial chondromatosis of the temporomandibular joint with glenoid fossa erosion
T2 - Disk preservation for spontaneous anatomical recovery
AU - Maffia, Francesco
AU - Vellone, Valentino
AU - De Quarto, Chiara
AU - Runci Anastasi, Michele
AU - Cascone, Piero
PY - 2019/12
Y1 - 2019/12
N2 - Synovial chondromatosis (SC) of the temporomandibular joint is a pseudoneoplastic condition characterized by benign cartilaginous metaplasia of synovial tissue mesenchymal residues with intra-articular nodule formation. TMJ involvement is rare. Interposition of loose bodies in the articular space can generate pressure, leading to glenoid fossa erosion with intracranial extension. The aim of this study was to present six SC cases with intracranial extension treated using a surgical procedure. All the patients were treated with open surgery. The superior compartment of the TMJ was opened widely to carefully remove the metaplasic mass. Temporal synovectomy was then performed. Attention was paid to preserving the integrity of the articular disc. The exposed dura mater was also preserved. No material was used to reconstruct the gap in the glenoid fossa. A 1-year follow-up showed no swelling or pain. Patients demonstrated good recovery of mouth opening, with improvement over previous mouth limitations. Morphological studies, performed using MRI and CT, showed complete anatomical recovery of the TMJ and total bone reconstruction of the glenoid fossa. Simple removal of intra-articular nodules, with TMJ arthroplasty and articular disk preservation, represents an efficient treatment option for full anatomical and functional recovery in synovial chondromatosis of the temporomandibular joint with glenoid fossa erosion of less than 1 cm2.
AB - Synovial chondromatosis (SC) of the temporomandibular joint is a pseudoneoplastic condition characterized by benign cartilaginous metaplasia of synovial tissue mesenchymal residues with intra-articular nodule formation. TMJ involvement is rare. Interposition of loose bodies in the articular space can generate pressure, leading to glenoid fossa erosion with intracranial extension. The aim of this study was to present six SC cases with intracranial extension treated using a surgical procedure. All the patients were treated with open surgery. The superior compartment of the TMJ was opened widely to carefully remove the metaplasic mass. Temporal synovectomy was then performed. Attention was paid to preserving the integrity of the articular disc. The exposed dura mater was also preserved. No material was used to reconstruct the gap in the glenoid fossa. A 1-year follow-up showed no swelling or pain. Patients demonstrated good recovery of mouth opening, with improvement over previous mouth limitations. Morphological studies, performed using MRI and CT, showed complete anatomical recovery of the TMJ and total bone reconstruction of the glenoid fossa. Simple removal of intra-articular nodules, with TMJ arthroplasty and articular disk preservation, represents an efficient treatment option for full anatomical and functional recovery in synovial chondromatosis of the temporomandibular joint with glenoid fossa erosion of less than 1 cm2.
KW - Disk preservation
KW - Intracranial extension
KW - Pseudoneoplastic metaplasia
KW - Synovial chondromatosis
KW - Temporomandibular joint disorder
KW - TMJ surgery
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U2 - 10.1016/j.jcms.2019.10.005
DO - 10.1016/j.jcms.2019.10.005
M3 - Article
C2 - 31690477
AN - SCOPUS:85074396167
VL - 47
SP - 1898
EP - 1902
JO - Journal of Maxillofacial Surgery
JF - Journal of Maxillofacial Surgery
SN - 1010-5182
IS - 12
ER -