Aguilo-Seara Gabriela, Runyan Christopher Michael
School of Medicine.
Department of Plastic and Reconstructive Surgery, Wake Forest University, Winston-Salem, NC.
J Craniofac Surg. 2018 Oct;29(7):e680-e682. doi: 10.1097/SCS.0000000000004864.
Ganglion cysts within the temporomandibular joint (TMJ), although uncommon, typically present with swelling, pain, trismus, and difficulty with mastication. The authors report an unusual case of a ganglion cyst in the TMJ of a 52-year-old man who presented with chief complaints of severe headaches and dizziness that had not subsided following treatment with medication, trigger point injections, or sphenopalatine ganglion blocks. The cyst appeared as a nonenhancing, T2 hyperdensity adjacent to the left TMJ condyle on magnetic resonance imaging, supported by the presence of chronic erosion and remodeling of the anterior aspect of the left condylar head on computed tomography. The cyst was surgically removed, and the patient reported that the migraines and accompanying dizziness had ceased 6 months postoperatively. The patient's presentation and improvement following surgery suggest that the location of the cyst in the TMJ and its proximity to the course of the auriculotemporal nerve may have caused auriculotemporal neuralgia, mimicking the symptoms of migraine.
颞下颌关节（TMJ）内的腱鞘囊肿虽不常见，但通常表现为肿胀、疼痛、牙关紧闭和咀嚼困难。作者报告了一例不同寻常的病例，一名52岁男性的颞下颌关节出现腱鞘囊肿，其主要症状为严重头痛和头晕，在接受药物治疗、触发点注射或蝶腭神经节阻滞治疗后仍未缓解。磁共振成像显示，囊肿表现为左侧颞下颌关节髁突旁的无强化T2高信号，计算机断层扫描显示左侧髁突头部前方存在慢性侵蚀和重塑，进一步支持了这一诊断。囊肿通过手术切除，患者报告术后6个月偏头痛和伴随的头晕症状消失。患者的临床表现及术后改善情况表明，囊肿在颞下颌关节的位置及其与耳颞神经走行的接近程度可能导致了耳颞神经痛，从而出现偏头痛症状。
