Meng Juan-hong, Guo Chuan-bin, Ma Xu-chen
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Center for Temporomandibular Joint Disorder and Orofacial Pain, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2014 Feb 18;46(1):43-7.
To give a reference for the early diagnosis and treatment of the cysts arising from the temporomandibular joint.
Nine patients finally diagnosed as temporomandibular joint cysts at the Peking University Hospital of Stomatology from May 1998 to August 2013 were selected and reviewed. Their clinical manifestations, imaging features, diagnoses and differential diagnoses, treatments and follow-ups were summarized and discussed.
In the 9 patients, 3 were males and 6 females. Their ages ranged from 33 to 62 years with a median age of 39 years; the course of the disease ranged from 2 weeks to 3 years with a median of 4 months. The image examinations were performed with conventional X-ray examinations in 7 cases, CT scans in 8 cases, MRI in 6 cases and ultrasound in one case. Of the 9 cases, 7 were finally diagnosed as ganglion cyst and 2 as synovial cyst. Ganglion cysts mainly presented as the mass of preauricular area or joint area, with no obvious symptoms or only local discomfort, occasionally with pain. The synovial cysts manifested as the painful swelling of preauricular area and limited mouth-opening, accompanying with occlusal disorders. The treatments included surgical resection in 8 cases, repeated arthrocenteses and lavages in one case. The follow-ups were from 3 months to 9 years, one case with recurrence, and the remaining eight cases without recurrence.
MRI examinations are very helpful in the early diagnosis and treatment planning of temporomandibular joint cysts. Surgical resection can have good results. Repeated arthrocenteses and lavages also have a good result, which may be an alternative choice for synovial cyst, but more accumulation of clinical experience is further needed.
为颞下颌关节囊肿的早期诊断和治疗提供参考。
选取1998年5月至2013年8月在北京大学口腔医院最终诊断为颞下颌关节囊肿的9例患者进行回顾性研究。总结并讨论其临床表现、影像学特征、诊断与鉴别诊断、治疗及随访情况。
9例患者中,男性3例,女性6例。年龄33~62岁,中位年龄39岁;病程2周~3年,中位病程4个月。7例行常规X线检查,8例行CT扫描,6例行MRI检查,1例行超声检查。9例中,7例最终诊断为腱鞘囊肿,2例为滑膜囊肿。腱鞘囊肿主要表现为耳前区或关节区肿物,无明显症状或仅有局部不适,偶有疼痛。滑膜囊肿表现为耳前区疼痛性肿胀、张口受限,伴有咬合紊乱。治疗方法包括8例手术切除,1例反复关节穿刺冲洗。随访3个月至9年,1例复发,其余8例未复发。
MRI检查对颞下颌关节囊肿的早期诊断及治疗方案的制定有很大帮助。手术切除效果良好。反复关节穿刺冲洗也有较好效果,可能是滑膜囊肿的一种替代选择,但还需要更多临床经验的积累。