Benign temporomandibular joint tumours with extension to infratemporal fossa and skull base: condyle preserving approach |
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| Institution: | 1. Department of Oral Surgery, Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China;2. Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt;1. Professor and Head, Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India;2. Ex-Junior Resident, Department of Oral & Maxillofacial surgery, All India Institute of Medical Sciences, New Delhi, India;3. Professor, Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India;4. Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India;6. Associate Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India;5. Professor and Head, Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India;1. Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan;2. Department of Oral and Maxillofacial Surgery, Division of Surgery, Tokai University School of Medicine, Isehara, Japan;3. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;4. First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Osaka, Japan;5. Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan;6. Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan;7. Department of Oral Surgical Oncology, Hokkaido Cancer Center, Sapporo, Japan;1. Department of Oral and Maxillofacial Surgery, Barzilai University Medical Center, Ashkelon, Israel;2. Faculty of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel;3. Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA;4. Oral and Maxillofacial Department, Galilee Medical Center, The Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel;5. Department of Otolaryngology – Head and Neck Surgery, Galilee Medical Center, The Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel;6. Oral and Maxillofacial Department, Medical Center, Nahariya, The Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel;1. Department of Oral and Maxillofacial Surgery, Charles University and Faculty Hospital Prague, Czech Republic;2. Department of Oral and Maxillofacial Surgery, Faculty Hospital Bratislava, Ruzinov, Slovakia |
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| Abstract: | This article introduces a modified surgical approach combining condylotomy with posterior disc attachment release for the resection of large non-malignant masses located in the infratemporal fossa and involving the skull base. This retrospective study included 14 patients treated at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University between January 2010 and December 2016. Clinical evaluations (visual analogue scale (VAS) for pain, maximum inter-incisal opening (MIO), and complications) and radiological findings (magnetic resonance imaging (MRI) and computed tomography (CT)) were collected pre- and postoperatively. All patients had satisfactory surgical exposure and complete resection of the neoplasms. During an average follow-up of 54.8 months, no clinical or radiographic signs of recurrence were reported. MIO increased from 28 mm preoperatively to 35.4 mm postoperatively (P < 0.001). The pain VAS score changed from 5.4 preoperatively to 0.7 postoperatively (P < 0.001). Neural function was normal for all patients. Postoperative MRI and CT scans showed a satisfactory disc position and condyle morphology, with no resorption. Three-dimensional reconstruction of the postoperative CT scan also demonstrated healing of the skull base defects. The modified surgical approach combining condylotomy with posterior disc attachment release is suitable for the removal of large non-malignant masses involving the infratemporal fossa and skull base. |
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| Keywords: | Infratemporal fossa tumor Skull base Condylotomy Posterior disc attachment relsease TMJ |
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