Transcondylar approach assisted with anterior release of the disc for a huge myxoma in infratemporal space: a case report

doi:10.19438/j.cjoms.2017.01.021

Abstract

Abstract: Juxta-articular myxoma is a benign tumor originating from the soft tissue related to the joints, such as the tendon sheath and ligament. According to our knowledge, there was no report on juxta-articular myxoma located in the temporomandibular joint (TMJ) before. In this paper, a rare juxta-articular myxoma occurring in the TMJ, anteromedially extending to the infratemporal fossa (ITF) was reported. A novel surgical method using transcondylar approach assisted with the anterior release of the disc for this unique case was used for excision of the tumor. At 30-month of follow-up, the patient recovered with neither cosmetic problems nor limitation of mouth opening. No sign of local recurrence was found on imaging examinations. The results suggested that the novel approach could not only preserve the structure and function of the TMJ, but also help complete exposure and excision of the tumor.

Key words: Juxta-articular myxoma, Temporomandibular joint, Infratemporal space, Transcondylar approach, Anterior release of the disc

CLC Number:

R782.1

YE Zhou-xi, YANG Chi, CHEN Min-jie. Transcondylar approach assisted with anterior release of the disc for a huge myxoma in infratemporal space: a case report[J]. China Journal of Oral and Maxillofacial Surgery, 2017, 15(1): 94-96.

References

[1] Allen PW. Myxoma is not a single entity: a review of the concept of myxoma [J]. Ann Diagn Pathol, 2000, 4(2): 99-123.
[2] Somford MP, de Vries JS, Dingemans W, et al. Juxta-articular myxoma of the knee [J]. J Knee Surg, 2011, 24(4): 299-301.
[3] Körver RJ, Theunissen PH, van de Kreeke WT, et al. Juxta-articular myxoma of the knee in a 5-year-old boy: a case report and review of the literature[J]. Eur Radiol, 2010, 20(3): 764-768.
[4] Tse JJ, Vander S. The soft tissue myxoma of the head and neck region-report of a case and literature review[J]. Head Neck Surg, 1985, 7(6): 479-483.
[5] Epivatianos A, Iordanidis S, Zaraboukas T. Myxoma of the oral soft tissues: report of a case and literature review [J]. J Oral Maxillofac Surg, 2007, 65(2): 317-320.
[6] Papadogeorgakis N, Petsinis V, Nikitakis N, et al. Intramuscular myxoma of the masseter muscle. A case report [J]. Oral Maxillofac Surg, 2009, 13 (1): 37-40.
[7] Gardner AW. Superficial angiomyxoma of the floor of the mouth-a case report [J]. Br J Oral Maxillofac Surg, 2007, 45(5): 418-419.
[8] Yoshida K, Kawase T, Tomita T, et al. Surgical strategy for tumors located in or extending from the intracranial space to the infratemporal fossa-Advantages of the transcranial approach (zygomatic infratemporal fossa approach) and the indications for a combined transcranial and transcervical approach [J]. Neurol Med Chir (Tokyo), 2009, 49(12): 580-586.
[9] He D, Yang C, Zhang S, et al. Modified temporomandibular joint disc repositioning with miniscrew anchor: part I-surgical technique [J]. J Oral Maxillofac Surg, 2015, 73(1): 47.e1-9.
[10] Meiz JM, Enzinger FM. Juxta-articular myxoma: a clinical and pathologic study of 65 cases [J]. Hum Pathol, 1992, 23(6): 639-646.
[11] Graadt van Roggen JF, Hogendoorn PC, Fletcher CD. Myxoid tumours of soft tissue [J]. Histopathology, 1999, 35(4): 291-312.
[12] Beggan C, Davies K, Leader M. Juxta-articular myxoma: an unusual benign mesenchymal lesion, readily mistaken for malignancy [J]. Ir Med J, 2014, 107(7): 212-213.
[13] Murphey MD, McRae GA, Fanburg-Smith JC, et al. Imaging of soft-tissue myxoma with emphasis on CT and MR and comparison of radiologic and pathologic findings [J]. Radiology, 2002, 225(1): 215-224.
[14] 皮昕, 李春芳. 口腔解剖生理学[M]. 第6版. 北京: 人民卫生出版社, 2010: 232-233.
[15] Ong HS, Zhang CP, Wu YQ, et al. Update on the surgical management of temporomandibular joint-centered tendon sheath giant cell tumor with intradural extension: introducing a cost-effective method in using temporal bone for skull base reconstruction in preventing brain hernia [J]. J Craniofac Surg, 2014, 25(5): 1769-1772.
[16] Yang XJ, Yang C, Chen MJ, et al. Preauricular transcondylar approach for basal cell adenoma of parotid coexist with ganglion cyst of the ipsilateral temporomandibular joint[J]. J Craniofac Surg, 2011, 22(6): e23-26.
[17] Tiwari R, Quak J, Egeler S, et al. Tumors of the infratemporal fossa [J]. Skull Base Surg, 2000, 10(1): 1-9.
[18] Guo Y, Guo C. Maxillary-fronto-temporal approach for removal of recurrent malignant infratemporal fossa tumors: anatomical and clinical study[J]. J Craniomaxillofac Surg, 2014, 42(3): 206-212.