Synovial chondromatosis of the temporomandibular joint with glenoid fossa erosion: Disk preservation for spontaneous anatomical recovery.

Abstract

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.

• Authors: Francesco Maffia, Valentino Vellone, Chiara De Quarto, Michele Runci Anastasi, Piero Cascone
• Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 47 Issue 12 Pg. 1898-1902 (Dec 2019) ISSN: 1878-4119 [Electronic] Scotland
• PMID: 31690477 (Publication Type: Journal Article)
• Copyright: Copyright © 2019 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Topics

• Adult
• Chondromatosis, Synovial (diagnostic imaging, surgery)
• Cranial Fossa, Middle (pathology, surgery)
• Female
• Glenoid Cavity
• Humans
• Joint Dislocations
• Joint Loose Bodies
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Temporomandibular Joint (diagnostic imaging)
• Temporomandibular Joint Disorders (diagnostic imaging, surgery)
• Tomography, X-Ray Computed
• Treatment Outcome