Successful Function-Preserving Therapy for Chondroblastoma of the Temporal Bone Involving the Temporomandibular Joint

Abstract

We present a case involving a late diagnosis of chondroblastoma of the temporal skull base involving the temporomandibular joint (TMJ). Following an initial misdiagnosis and unsuccessful treatment over a period of 5 years, the patient was referred to our department for further evaluation and possible surgical intervention for occlusal abnormalities, trismus, clicking of the TMJ, and hearing impairment. Based on preoperative immunochemical studies showing positive reaction of multinucleated giant cells for S-100 protein, the final diagnosis was chondroblastoma. The surgical approach – postauricular incision and total parotidectomy, with complete removal of the temporal bone, including the TMJ via the extended middle fossa – was successful in preserving facial nerves and diminishing clinical manifestations. This study highlights a misdiagnosed case in an effort to underline the importance of medical examinations and accurate differential diagnosis in cases involving any tumor mass in the temporal bone.

Variants and Modifications of the Retroauricular Approach Using in Temporomandibular Joint Surgery: A Systematic Review

“…Thus, the highest level of evidence is in the cohort studies by Kolk et al and Bansal et al [ 4 , 5 ]. All the collected material concerns papers with a high risk of bias, including case control studies and even case reports [ 6 , 7 , 15 , 21 ]. Therefore, the results presented below are intended for experienced surgeons and should only be taken as suggestions and not expressions of evidence-based medicine.…”

“…In the case of the bat wing approach, the original nomenclature was retained [ 14 ]. In the course of an extensive ablation surgery described by Yokoyama et al, RA was only a fragment of the approach, and the temporomandibular joint constituted only a part of the resected tissues, so this case will not be analyzed any further [ 21 ]. In regard to the above comments, the data collected from the different RA applications was combined into 2 main variants and 2 modifications, as shown in Table 6 .…”

Chondroblastoma of mandibular condyle: Case report and literature review

“…Primary bone tumors of the craniofacial bone are not common, comprising 2% of all primary bone tumors [ 3 ]. Chondroblastomas that arise in the craniofacial bone, particularly in the mandibular condyle, are rarer than other bones [ 1 , 4 , 5 , 6 , 7 , 8 ]. The current treatment recommendation is en bloc excision with preservation of important neurovascular structures [ 9 , 10 ].…”