BACKGROUND Pseudogout is a benign joint lesion caused by the deposition of calcium pyro-phosphate dihydrate crystals, but it is invasive. Pseudogout of the temporo-mandibular joint (TMJ) is uncommon, and it rarely invades the skull base or penetrates into the middle cranial fossa. The disease has no characteristic clinical manifestations and is easily misdiagnosed. CASE SUMMARY We present two cases of tophaceous pseudogout of the TMJ invading the middle cranial fossa. A 46-year-old woman with a history of diabetes for more than 10 years was admitted to the hospital due to swelling and pain in the right temporal region. Another patient, a 52-year-old man with a mass in the left TMJ for 6 years, was admitted to the hospital. Maxillofacial imaging showed a calcified mass and severe bone destruction of the skull base in the TMJ area. Both patients underwent excision of the lesion. The lesion was pathologically diagnosed as tophaceous pseudogout. The symptoms in these patients were relieved after surgery. CONCLUSION Tophaceous pseudogout should be considered when there is a calcified mass in the TMJ with or without bone destruction. A pathological examination is the gold standard for diagnosing this disease. Surgical treatment is currently the recommended treatment, and the prognosis is good after surgery.

Aim: Ear reconstruction is a challenge for plastic and reconstructive surgeons. The ear requires sufficient skin coverage and a three-dimensional (3D) cartilage framework. In this paper, the authors present their 10-year experience in microtia reconstruction using tissue expansion and an autogenous rib cartilage framework. Methods: Ear reconstruction was performed in 3 operative stages. During the first procedure, a 50-80 mL kidney or cylinder-shaped expander was implanted deep to the subcutaneous fascia of the retroauricular mastoid region. Over a period of 3-5 months, the expander was filled to a final volume of 80-110 mL. In the next operation, the retroauricular fascia was eliminated or reserved following expander removal, and the autogenous costal cartilage framework was placed below the expanded skin flap. At the third and final stage, the earlobe transposition, tragus construction and conchal deepening were performed. Results: A total of 165 patients (166 ears) were reconstructed using tissue expansion and an autogenous rib cartilage framework. Complications included hematomas in 3 cases, expander exposure in 8 cases, cartilage exposure in 6 cases, infection and cartilage resorption in 2 cases, exposure of steel wire in 4 cases, and aseptic seroma in 2 cases. Follow-up ranging from 3 months to 5 years showed that 159 patients were satisfied with the reconstructed ear including size, location, projection, convolution, skin-colour matching, symmetry with opposite ear. Conclusion: Expansion of the retroauricular skin and fascia can provide sufficient non-hair-bearing skin and tissue for coverage of a three-dimensional costal cartilage framework. Avoidance and prompt treatment of complications are advised in order to obtain a satisfactory reconstruction of the ear. Key words:Microtia, expansion, autogenous costal cartilage, ear reconstruction ABSTRACTArticle history:

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