Morey-Mas Miguel-Angel, Caubet-Biayna Jorge, Iriarte-Ortabe José-Ignacio
Department of Oral and Maxillofacial Surgery, Son Dureta University Hospital Palma de Mallorca Spain.
Bone regeneration and Oral and Maxillofacial Surgery Unit (GBCOM), Hospital Son Dureta Insalud, Baleares Spain.
J Oral Maxillofac Res. 2011 Jan 1;1(4):e4. doi: 10.5037/jomr.2010.1404. eCollection 2011.
Osteochondromas are one of the most common benign tumours of bone, but they are rare in the craniofacial region. These condylar tumours have been variably treated, including resection through local excision or condylectomy with or without reconstruction.
A case of osteochondroma of the mandibular condyle and cranial base arising concurrently in the 76 years old patient was presented. The surgical excision of the skull base lesion and condylectomy with immediate reconstruction of temporomandibular joint was applied.
Based on the history, clinical examination and radiographic findings, osteochondroma of the skull base was diagnosed, with a concurrent lesion of the condylar process. Treatment methods for this patient included excision of the skull base tumour and condylectomy with immediate temporomandibular joint reconstruction using appropriately sized stock total temporomandibular joint prosthesis. At the 24 month follow-up, patient was free of pain and her maximal incisal opening was maintained, with no radiographic evidence of tumour recurrence or failure of the device.
Temporomandibular joint stock total replacement prosthesis became a good option to reconstruct both the fossa and the condyle in a one-stage surgery, due to the fact that both the condylar/mandibular and the fossa implants were stable in situ from the moment of fixation, with a good outcome at 24 month follow-up, with no loosening of the screws nor failure of the device.
骨软骨瘤是最常见的骨良性肿瘤之一，但在颅面部区域较为罕见。这些髁突肿瘤的治疗方法多样，包括通过局部切除或髁突切除术进行切除，可选择或不进行重建。
报告一例76岁患者同时发生下颌髁突和颅底骨软骨瘤的病例。采用手术切除颅底病变并进行髁突切除，同时立即重建颞下颌关节。
根据病史、临床检查和影像学检查结果，诊断为颅底骨软骨瘤，同时伴有髁突病变。该患者的治疗方法包括切除颅底肿瘤和髁突切除，同时使用尺寸合适的库存全颞下颌关节假体立即重建颞下颌关节。在24个月的随访中，患者无疼痛，最大切牙开口度得以维持，影像学检查未发现肿瘤复发或假体失败的迹象。
颞下颌关节库存全置换假体成为一期手术中重建关节窝和髁突的良好选择，因为髁突/下颌和关节窝植入物自固定时起在原位稳定，在24个月的随访中效果良好，螺钉未松动，假体未失败。
