Kwon Kwang-Jun, Seok Hyun, Lee Jang-Ha, Kim Min-Keun, Kim Seong-Gon, Park Hyung-Ki, Choi Hang-Moon
1Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 25457 Republic of Korea.
2Department of Oral and Maxillofacial Surgery, Chungbuk National University Hospital, Cheongju, 28644 Republic of Korea.
Maxillofac Plast Reconstr Surg. 2018 Aug 3;40(1):19. doi: 10.1186/s40902-018-0158-0. eCollection 2018 Dec.
Calcium pyrophosphate dihydrate deposition disease (CPDD) is a rare disease in the temporomandibular joint (TMJ) space. It forms a calcified crystal mass and induces a limitation of joint movement.
The calcified mass in our case was occupied in the left TMJ area and extended to the infratemporal and middle cranial fossa. For a complete excision of this mass, we performed a vertical ramus osteotomy and resected the mass around the mandibular condyle. The calcified mass in the infratemporal fossa was carefully excised, and the segmented mandible was anatomically repositioned. Scanning electronic microscopy (SEM)/energy-dispersive X-ray spectroscopy (EDS) microanalysis was performed to evaluate the calcified mass. The result of SEM/EDS showed that the crystal mass was completely composed of calcium pyrophosphate dihydrate. This result strongly suggested that the calcified mass was CPDD in the TMJ area.
CPDD in the TMJ is a rare disease and is difficult to differentially diagnose from other neoplasms. A histological examination and quantitative microanalysis are required to confirm the diagnosis. In our patient, CPDD in the TMJ was successfully removed via the extracorporeal approach. SEM/EDS microanalysis was used for the differential diagnosis.
二水焦磷酸钙沉积病（CPDD）在颞下颌关节（TMJ）间隙中是一种罕见疾病。它形成钙化晶体团块并导致关节活动受限。
我们病例中的钙化团块占据左侧颞下颌关节区域并延伸至颞下窝和中颅窝。为了完整切除该团块，我们进行了下颌支垂直截骨术，并切除了下颌髁突周围的团块。仔细切除了颞下窝中的钙化团块，并将分段的下颌骨进行了解剖复位。进行了扫描电子显微镜（SEM）/能量色散X射线光谱（EDS）微分析以评估钙化团块。SEM/EDS结果显示晶体团块完全由二水焦磷酸钙组成。这一结果强烈提示该钙化团块为颞下颌关节区域的CPDD。
颞下颌关节的CPDD是一种罕见疾病，难以与其他肿瘤进行鉴别诊断。需要进行组织学检查和定量微分析以确诊。在我们的患者中，颞下颌关节的CPDD通过体外入路成功切除。SEM/EDS微分析用于鉴别诊断。
