Pigmented Villonodular Synovitis Presenting as Unilateral Hearing Loss: Review of the Literature and Case Report.

BACKGROUND/AIMS: To review the existing literature on pigmented villonodular synovitis (PVNS) of the temporomandibular joint (TMJ) and report a rare case of PVNS of the TMJ presenting with unilateral hearing loss.

METHODS

Review of the existing literature and a description of personal experience with PVNS of the TMJ presenting with unilateral hearing loss.

RESULTS

Review of the existing literature revealed 76 reported cases of PVNS of the TMJ. The most common presenting symptom was of a slowly enlarging mass or swelling of the preauricular area, with dysfunctional TMJ also frequently reported. All patients underwent surgical excision with some pursuing radiation as adjuvant therapy. Presented Patient: A 46-year-old man presented with several months of unilateral subjective hearing loss and aural fullness. Imaging revealed a mass centered along the superior TMJ with expansion through the squamous temporal bone and extra-axial intracranial extension into the middle cranial fossa. Imaging characteristics and fine-needle aspiration biopsy were consistent with PVNS.

INTERVENTION

The patient underwent near-total excision of the mass via frontotemporal craniectomy and lateral temporal bone resection.

FOLLOW-UP: At the 16-month follow-up there was no evidence of disease recurrence.

CONCLUSION

PVNS of the TMJ represents a rare entity that can present with a variety of symptoms including unilateral hearing loss.