Heeyeon Bae1, Dong-Mok Ryu2,3, Hyung Kyung Kim4, Sung-Ok Hong2, Hyen Woo Lee2, Youngjin Shin2, Yu-Jin Jee5,6. 1. Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gang-dong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea. baehy0426@gmail.com. 2. Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gang-dong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea. 3. Department of Oral and Maxillofacial Surgery, College of Dentistry, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea. 4. Department of Pathology, Kyung Hee University Hospital at Gang-dong, Seoul, Republic of Korea. 5. Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gang-dong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea. omsjyj@khu.ac.kr. 6. Department of Oral and Maxillofacial Surgery, College of Dentistry, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea. omsjyj@khu.ac.kr.
Abstract
BACKGROUND: Chondroblastomas, which account for approximately 1% of all bone tumors, typically occur in long bones, such as the femur, humerus, and tibia. However, in extremely rare cases, they may also occur in the craniofacial region where the tumor is often found in the squamous portion of the temporomandibular joint (TMJ) and in the temporal bone. CASE PRESENTATION: This case report describes a large chondroblastoma (diameter, approximately 37 mm) that occurred in the TMJ. The tumor was sufficiently aggressive to destroy the TMJ, mandibular condyle neck, external auditory canal (EAC), mandibular fossa of the temporal bone, and facial nerve. The tumor was completely excised using a pre-auricular approach. The EAC and surgical defect were successfully reconstructed using a temporoparietal fascia flap (TPFF) and an inguinal free fat graft. There was no local tumor recurrence at the 18-month follow-up visits. However, the patient developed sensory neural hearing loss, and his eyebrow paralysis worsened, eventually requiring plastic surgery. CONCLUSION: Large, invasive chondroblastomas of the TMJ can be completely removed through a pre-auricular approach, and the resulting surgical defect can be reconstructed using TPFF and free fat grafts. However, preoperative evaluation of the facial nerve and auditory function is necessary. Therefore, a multidisciplinary approach is essential.
BACKGROUND:Chondroblastomas, which account for approximately 1% of all bone tumors, typically occur in long bones, such as the femur, humerus, and tibia. However, in extremely rare cases, they may also occur in the craniofacial region where the tumor is often found in the squamous portion of the temporomandibular joint (TMJ) and in the temporal bone. CASE PRESENTATION: This case report describes a large chondroblastoma (diameter, approximately 37 mm) that occurred in the TMJ. The tumor was sufficiently aggressive to destroy the TMJ, mandibular condyle neck, external auditory canal (EAC), mandibular fossa of the temporal bone, and facial nerve. The tumor was completely excised using a pre-auricular approach. The EAC and surgical defect were successfully reconstructed using a temporoparietal fascia flap (TPFF) and an inguinal free fat graft. There was no local tumor recurrence at the 18-month follow-up visits. However, the patient developed sensory neural hearing loss, and his eyebrow paralysis worsened, eventually requiring plastic surgery. CONCLUSION: Large, invasive chondroblastomas of the TMJ can be completely removed through a pre-auricular approach, and the resulting surgical defect can be reconstructed using TPFF and free fat grafts. However, preoperative evaluation of the facial nerve and auditory function is necessary. Therefore, a multidisciplinary approach is essential.