Faas I
Laryngol Rhinol Otol (Stuttg). 1983 Dec;62(12):574-7.
A 76-year old female patient was suffering from a right-sided conduction-type hearing loss due to a very painful tumour in the anterior parotid region. X-ray films showed a partial destruction of the right temporomandibular joint. Since the patient had undergone a left-sided mastectomy for breast carcinoma two years previously, an operation was performed under the suspicion of a metastatic lesion. A plum-sized gouty tophus was found adjacent to the temporomandibular joint. The head of the mandible was partly destroyed, the upper pole of the parotid gland displaced and atrophic. The dorsal and medial aspect of the tophus impinged on the cartilaginous portion of the Eustachian tube. In the postoperative course, the conduction-type deafness disappeared, the pain was relieved, and the mobility of the joint almost completely restored. To our knowledge this represents the second case of a gouty tophus in the temporomandibular joint, the first one where the size of the lesion resulted in impingement of the Eustachian tube and conduction-type deafness. It is noteworthy that the patient showed no other signs or symptoms of primary gouty arthritis.
一名76岁女性患者因腮腺前区出现非常疼痛的肿瘤而患有右侧传导性听力损失。X线片显示右侧颞下颌关节部分破坏。由于该患者两年前曾因乳腺癌接受左侧乳房切除术，因此在怀疑有转移性病变的情况下进行了手术。在颞下颌关节附近发现一个李子大小的痛风石。下颌骨头部部分被破坏，腮腺上极移位并萎缩。痛风石的背侧和内侧压迫咽鼓管的软骨部分。在术后过程中，传导性耳聋消失，疼痛缓解，关节活动度几乎完全恢复。据我们所知，这是颞下颌关节痛风石的第二例病例，第一例病例中病变大小导致咽鼓管受压和传导性耳聋。值得注意的是，该患者没有原发性痛风性关节炎的其他体征或症状。
