Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No.324. Jing Six Road, Jinan, Shandong, China.
Department of Stomatology, Zibo First Hospital, Zibo, Shandong, China.
J Stomatol Oral Maxillofac Surg. 2023 Dec;124(6 Suppl 2):101580. doi: 10.1016/j.jormas.2023.101580. Epub 2023 Aug 2.
Ectopic mandibular third molar (EMTM) in the subcondylar region is a rare clinical condition, especially for a subtype confined between the mandibular foramen and condylar neck. The etiology is currently uncertain and the optimal management of this specific subtype remains not well defined. We reported a case of this specific subtype of EMTM that was minimally invasively extracted by endoscopy-guided intraoral surgery, planned preoperatively using three-dimensional (3D) imaging of cone beam computed tomography (CBCT), with no complications postoperatively caused by the routine surgery. We also reviewed nine relevant literature to expand the clinical features and therapeutic management of this specific subtype of EMTM. Etiologically, persistent cystic pressure may be a major cause of EMTM displaced into the subcondylar region. For extraction of this specific EMTM, the combination of 3D CBCT-based imaging and endoscopy-assisted intraoral minimally invasive surgery could be considered as the priority option for patients without facial fistula.
髁突下异位第三磨牙（EMTM）是一种罕见的临床病症，特别是在下颌孔和髁突颈之间局限的亚型更为罕见。其病因目前尚不确定，对于这种特殊亚型的最佳治疗方案仍未明确。我们报告了一例经内镜引导的口腔内微创手术微创拔除的该特殊亚型 EMTM 病例，术前使用锥形束 CT（CBCT）的三维（3D）成像进行了规划，常规手术无术后并发症。我们还回顾了 9 篇相关文献，以扩展该特殊亚型 EMTM 的临床特征和治疗管理。从病因学上讲，持续的囊性压力可能是 EMTM 移位至髁突下区域的主要原因。对于这种特殊 EMTM 的拔除，结合基于 3D CBCT 的成像和内镜辅助的口腔内微创手术可以被认为是没有面部瘘管的患者的首选方案。
