Objective
Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a synovial membrane
disease characterized by the formation of cartilaginous nodules (CN), that may erode
the skull base. Historically, cases with skull base involvement have been treated
with open surgery. We report a case of TMJ SC with skull base perforation treated
and repaired via minimally invasive TMJ arthroscopy and describe the advanced endoscopic
operative maneuvers performed.
Case Report
A 34-year-old male presented with a 4-year history of malocclusion and right TMJ arthralgia.
Clinical examination demonstrated malocclusion and direct pressure loading pain. Advanced
imaging revealed glenoid fossa erosion and numerous homogenous hypointense lesions
within an effusion. The initial surgical plan included diagnostic TMJ arthroscopy
followed by conversion to open arthroplasty. Endoscopic operative maneuvers allowed
for the accomplishment of the surgical goals, completely arthroscopically. Histopathology
confirmed SC, and the patient remains on observation, with relief of symptoms.
Conclusion
Advanced arthroscopy is a viable treatment option for select cases of TMJ SC with
skull base involvement that allowed for access to the joint space, retrieval of biopsy
specimens and CN, and repair of the skull defect.
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Article info
Publication history
Published online: November 23, 2022
Accepted:
November 16,
2022
Received in revised form:
November 8,
2022
Received:
August 24,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
