Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

INFLAMMATORY SYNOVIAL CYST OF THE TEMPOROMANDIBULAR JOINT: A CASE REPORT

측두하악관절에 발생한 염증성 활액낭

  • Cho, Myung-Chul (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Yongdong Severance Dental Hospital)) ;
  • Huh, Jong-Ki (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Yongdong Severance Dental Hospital)) ;
  • Hong, Soon-Won (Department of Pathology, College of Medicine, Yonsei University) ;
  • Kim, Jin-Tae (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Yongdong Severance Dental Hospital)) ;
  • Jeon, Kug-Jin (Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University) ;
  • Kim, Hyung-Gon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University (Yongdong Severance Dental Hospital))
  • 조명철 (연세대학교 치과대학 구강악안면외과학교실(영동세브란스치과병원)) ;
  • 허종기 (연세대학교 치과대학 구강악안면외과학교실(영동세브란스치과병원)) ;
  • 홍순원 (연세대학교 의과대학 병리학교실) ;
  • 김진태 (연세대학교 치과대학 구강악안면외과학교실(영동세브란스치과병원)) ;
  • 전국진 (연세대학교 치과대학 구강악안면방사선과학교실) ;
  • 김형곤 (연세대학교 치과대학 구강악안면외과학교실(영동세브란스치과병원))
  • Published : 2008.05.30
Download PDF
⟨ Previous Next ⟩

Abstract

Temporomandibular joint cysts usually occur between the second and fourth decade of life. There is a female predominance to male of approximately 3 to 1. The patients complain of swelling, pain and sometimes decreased mouth opening. Synovial cysts of the temporomandibular joint seem to develop by an increase of intraarticular pressure due to trauma or inflammation which causes capsular herniation. However, if inflammatory synovial cysts develop by an increase of synovial fluid into inflammation tissue in the capsule without capsular herniation, a differential diagnosis should include synovial chondromatosis and synovitis. This is a case report of a synovial cyst developed in a capsule of the temporomandibular joint.

활액낭은 측두하악관절에 매우 드물게 나타나는 질환으로 본 증례는 개구제한을 주소로 내원하여 측두하악관절장애로 의심하고 자기공명 영상검사를 시행하였다. T2강조영상에서 좌측 측두하악관절강내에 다량의 활액이 관찰되었으나 전형적인 활액막 연골종증과 달리 상하관절강내의 활액이 격벽에 의해 분리되어 있었으며 수술시 낭성 병변이 관찰되었다. 조직학적으로 낭주위가 활액세포로 이장되어 있는 진성낭이었으며 낭벽내에 신생혈관 및 염증세포의 침윤이 관찰되어 염증성 활액낭으로 최종 진단하였다. 이 증례는 특징적인 자기공명영상소견을 나타내었지만 타 질환과 감별에 많은 어려움이 있었다. 치료는 병소의 적출을 시행하였으며 추적관찰기간 동안 재발은 보이지 않았다.

Keywords

References

  1. Janecka IP, Conley JJ : Synovial cyst of temporomandibular joint imitating a parotid tumor. J Maxillofac Surg 6 : 154, 1978 https://doi.org/10.1016/S0301-0503(78)80083-6
  2. Bonacci CE, Lambert BJ, Pulse CL et al : Inflammatory synovial cyst of the temporomandibular joint : A case report and review of the literature. J Oral Maxillofac Surg 54 : 769, 1996 https://doi.org/10.1016/S0278-2391(96)90701-6
  3. Chang YM, Chan SF, Kung Wu SP et al : Ganglion cyst and synovial cyst of the temporomandibular joint. Two case reports. Int J Oral Maxillofac Surg 26 : 179, 1997
  4. Lomeo PE, McDonald JE, Finneman J : Temporomandibular joint cyst as a preauricular mass. Am J Otolaryngol 21 : 331, 2000 https://doi.org/10.1053/ajot.2000.16168
  5. Nahlieli O, Lewkowicz A, Hasson O et al : Ganglion cyst of the temporomandibular joint : Report of case and review of literature. J Oral Maxillofac Surg 58 : 216, 2000 https://doi.org/10.1016/S0278-2391(00)90342-2
  6. Silva EC, Guimaraes AL, Gomes CC et al : Ganglion cyst of the temporomandibular joint. Br J Oral Maxillofac Surg 43 : 77, 2005 https://doi.org/10.1016/j.bjoms.2004.08.016
  7. Kim HG, Park KH, Huh JK et al : Magnetic resonance imaging characteristics of synovial chondromatosis of the temporomandibular joint. J Orofac Pain 16 : 148, 2002
  8. Lopes V, Jones JA, Sloan P et al : Temporomandibular ganglion or synovial cyst? A case report and literature review. Oral Surg Oral Med Oral Pathol 77 : 627, 1994 https://doi.org/10.1016/0030-4220(94)90324-7
  9. Shiba R, Suyama T, Sakoda S : Ganglion of the temporomandibular joint. J Oral Maxillofac Surg 45 : 618, 1987 https://doi.org/10.1016/0278-2391(87)90274-6
  10. Goudot P, Jaquinet AR, Richter M : Cysts of the temporomandibular joint. Report of two cases. Int J Oral Maxillofac Surg 28 : 338, 1999 https://doi.org/10.1016/S0901-5027(99)80077-0
  11. Kim SG, Cho BO, Lee YC et al : Ganglion cyst of the temporomandibular joint. J Oral Pathol Med 32 : 310, 2003 https://doi.org/10.1034/j.1600-0714.2003.00115.x
  12. Gynther GW, Dijkgraaf LC, Reinholt FP et al : Synovial inflammation in arthroscopically obtained biopsy specimens from the temporomandibular joint : A review of the literature and a proposed histologic grading system. J Oral Maxillofac Surg 56 : 1281, 1998 https://doi.org/10.1016/S0278-2391(98)90609-7