De Moor Alexander, Willaert Robin, Sun Yi, Hunin Zoé, van Loon Johannes, Decramer Thomas, Bila Michel
OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, KU Leuven & Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium.
J Neurosurg Case Lessons. 2024 Aug 5;8(6). doi: 10.3171/CASE24132.
Meningoencephaloceles can originate through any defect in the cranial bones, including the skull base. They can be completely asymptomatic or present with typical symptoms such as headaches, seizures, or meningitis.
The authors present the case of a 54-year-old female who presented with right-sided ear and temporomandibular joint (TMJ) pain. Computed tomography showed a large lytic lesion of the squamous part of the temporal bone with cortical bone destruction, extending to the mandibular fossa. Magnetic resonance imaging demonstrated a temporal bone meningoencephalocele. The patient underwent resection, dural repair, and multilayer reconstruction with a patient-specific three-dimensional-printed titanium combined craniofossa prosthesis.
To the authors' knowledge, this is the first case report of TMJ pain associated with a temporal meningoencephalocele. The exact location and extension of the lesion determine the surgical approach and need for reconstruction in temporal bone meningoencephaloceles. In cases of destruction of the mandibular fossa, a patient-specific combined craniofossa prosthesis is recommended to reconstruct the bone defect. https://thejns.org/doi/10.3171/CASE24132.
脑膜脑膨出可起源于颅骨的任何缺损处，包括颅底。它们可以完全无症状，或表现为头痛、癫痫发作或脑膜炎等典型症状。
作者报告了一例54岁女性患者，该患者出现右侧耳部和颞下颌关节（TMJ）疼痛。计算机断层扫描显示颞骨鳞状部有一个大的溶骨性病变，伴有皮质骨破坏，延伸至下颌窝。磁共振成像显示为颞骨脑膜脑膨出。患者接受了切除、硬脑膜修复以及使用定制的三维打印钛合金联合颅窝假体进行多层重建。
据作者所知，这是第一例与颞骨脑膜脑膨出相关的颞下颌关节疼痛的病例报告。病变的确切位置和范围决定了颞骨脑膜脑膨出的手术入路和重建需求。在下颌窝破坏的病例中，建议使用定制的联合颅窝假体来重建骨缺损。https://thejns.org/doi/10.3171/CASE24132 。
