A large invasive chondroblastoma on the temporomandibular joint and external auditory canal: a case report and literature review
배희연, 류동목, 김현경, 홍성옥, 이현우, 신영진, 지유진,
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배희연 ( Bae Hee-Yeon ) - Kyung Hee University Dental Hospital at Gangdong Department of Oral and Maxillofacial Surgery
류동목 ( Ryu Dong-Mok ) - Kyung Hee University Dental Hospital at Gangdong Department of Oral and Maxillofacial Surgery
김현경 ( Kim Hyung-Kyung ) - Kyung Hee University Hospital at Gangdong Department of Pathology
홍성옥 ( Hong Sung-Ok ) - Kyung Hee University Dental Hospital at Gangdong Department of Oral and Maxillofacial Surgery
이현우 ( Lee Hyen-Woo ) - Kyung Hee University Dental Hospital at Gangdong Department of Oral and Maxillofacial Surgery
신영진 ( Shin Young-Jin ) - Kyung Hee University Dental Hospital at Gangdong Department of Oral and Maxillofacial Surgery
지유진 ( Jee Yu-Jin ) - Kyung Hee University Dental Hospital at Gangdong Department of Oral and Maxillofacial Surgery
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.
키워드
Chondroblastoma; Temporomandibular joint; Pre-auricular approach; Temporoparietal fascia flap; Inguinal fat graft; Multidisciplinary approach
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