Ganglion cyst of the temporomandibular joint with intracranial extension in a patient presenting with seventh cranial nerve palsy

Abstract

Ganglion cysts arising from the temporomandibular joint are rare entities that often present with swelling and minimal to no pain in the preauricular region. To the authors' knowledge, a temporomandibular joint ganglion cyst occurring with acute facial nerve palsy and intracranial extension has never been reported. The patient in the current case initially underwent treatment for Bell palsy and then draining of the cyst at an outside hospital with no relief of symptoms. Repeat MR imaging showed an increase in the size of the cystic, enhancing, middle fossa lesion measuring 4 cm. Resection of the lesion was undertaken using a middle fossa approach. After a satisfactory surgical decompression, the patient demonstrated a significant recovery in her facial palsy over a 3-month period of time. This case presents new clinical and radiographic findings associated with these lesions.

Facial Neuropathy With Imaging Enhancement of the Facial Nerve: A Case Report

“…Mumert et al speculated the cyst exerted a mass effect on the geniculate ganglion, the intratemporal segment or the extratemporal segment of the facial nerve [24]. Synovial cysts and ganglion cysts both can appear after trauma [24], although we did not see that in this case.…”

“…A case of a patient with a ganglion cyst of the temporomandibular joint presenting with facial nerve palsy has been reported [24]. Mumert et al speculated the cyst exerted a mass effect on the geniculate ganglion, the intratemporal segment or the extratemporal segment of the facial nerve [24].…”

An inferior alveolar intraneural cyst: a case example and an anatomical explanation to support the articular theory within cranial nerves

“…The TMJ is a synovial joint with more than 50 cases of (extraneural) cysts reported in the literature. Extraneural cysts in this location can be asymptomatic or symptomatic (causing neural symptoms due to extrinsic nerve compression 3,4,8,23,33 or mastication difficulties because of the mass 2,7,20,32 ). They are derived from the TMJ via non-neural pedicles and can extend in different directions, even intraosseously 2,8,16,26 or intracranially 18,23,33 (Fig.…”

Synovial Cyst of the Temporomandibular Joint

“…Synovial cyst is apparently a result of trauma in the TMJ area or displacement and/or herniation of the synovial lining. Most of the cases have been observed in females (Ali et al, 2006;Levarek et al, 2016;Mumert et al, 2012;Silva et al, 2005;Spinzia et al, 2011;Steen et al, 2015;Takaku et al, 2001;Vera-Sirera et al, 2013;Wu et al, 2011;Zheng et al, 2015). The most common symptoms are swelling, pain caused by the auriculotemporal nerve compression, and tenderness of the TMJ region.…”