Joined: 15 Feb 2008 Posts: 86 Location: Chicago, IL
right mandibular condylar cyst. Posted: 04-30-08 22:32pm
What happens if there is a cyst inside the
condyle and the pain is persistent and
getting worse with orthotic (splint)
treatment not helping.
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Tmddyan
Moderator
Joined: 13 Jun 2006 Posts: 4346 Location: post falls, id usa
Thanks: 93
Thanked:63
Posted: 05-01-08 13:44pm
then obviously you need to get in there
and be persistant. dont take no for an
answer. tell them what you think is wrong
and then go and tell them why.
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edgaras
Supporter
Joined: 15 Feb 2008 Posts: 86 Location: Chicago, IL
radiologist Posted: 05-02-08 17:27pm
I saw a radiologist for 2nd opinion.
Initially, he was quick to conclude that
there is no cyst (just like 2 previous
oral surgeons), but then upon me being
persistent he went on to look at the MRI
slides more carefully and did say, "yes
there is a cyst, but it is very unlikely
that it is causing you this pain, and
there is no fluid around the TMJ, so
arthocentesis is really not useful".
It is getting so hard to keep hearing same
thing - "your TMJ anatomy and physiology
appear normal so it is very unlikely that
is it causing "the amount of pain that YOU
describe".
And it all started with a root canal...
then extracted it, but pain continued.
Maybe dentist injected me in the wrong
place.
Initially I just had pain, then I noticed
that my joint is clicking, popping
(crepitus). Feels inflamed within like
pressure building up in locked chamber,
that's how it feels.
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Tmddyan
Moderator
Joined: 13 Jun 2006 Posts: 4346 Location: post falls, id usa
Thanks: 93
Thanked:63
Posted: 05-03-08 00:19am
beleive me i know how frustrating it is.
the amount of pain you describe---good
grief---offer to give your jaw to them for
a while. arthrocentesis doensnt really
work anyhow cause it only works with one
joint cavity
i know what you are going through---ive
been there. but im a little bit of a jerk
and i pester till i get what i
want---which sadly is what you have to
do---with my doctors i didnt need to --the
last set anyway cause they knew what i was
talking of and i had all my files and i
was well educated and i educated them
further. sometimes you have to do that as
well. you need to get that cyst out. see
if there is a med that they can use--you
may want to have them biopsy the cyst
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edgaras
Supporter
Joined: 15 Feb 2008 Posts: 86 Location: Chicago, IL
Posted: 05-05-08 23:44pm
Thanks for understanding Tmddyan.
At this particular point I am being forced
to research as my doctors confuse more
than help. Here is what I found on
pubmed.com; sadly, my university account
has expired so no more full access to
articles, I will try to regain that
feature as I cannot afford to travel to
university grounds to have access.
Why can't medical research be free to all,
but that's another question...
Temporomandibular joint neoplasms and
pseudotumors.
Warner BF, Luna MA, Robert Newland T.
Department of Pathology, University of
Texas M.D. Anderson Cancer Center,
Houston, USA.
Neoplasms and pseudotumors of the
temporomandibular joint (TMJ) are very
uncommon. Early recognition of such will
prevent therapeutic delay and may have a
dramatic impact on patient morbidity and
mortality. Included in rare TMJ lesions
are the following: 1) synovial
chondromatosis, 2) osteochondroma, 3)
osteoma, 4) osteoblastoma, 5) pigmented
villonodular synovitis, 6) ganglion, 7)
synovial cyst, simple bone cyst,
9) aneurysmal bone cyst, 10) epidermal
inclusion cyst, 11) hemangioma, 12)
nonossifying fibroma, 13) Langerhans cell
histiocytosis, 14) plasma cell myeloma,
15) sarcoma.
PMID: 11078060
Int J Oral Maxillofac Surg. 1997
Jun;26(3):179-81.Links
Ganglion cyst and synovial cyst of the
temporomandibular joint. Two case
reports.
Chang YM, Chan CP, Kung Wu SF, Hao SP,
Chang LC.
Department of Oral and Maxillofacial
Surgery, Chang Gung Memorial Hospital,
Taipei, Taiwan.
Ganglion cysts and synovial cysts are
lesions rarely associated with the
temporomandibular joint. Ganglion cysts
arise from myxoid degeneration of the
connective tissue of the joint capsule,
are filled with viscoid fluid or
gelatinous material, and have a fibrous
lining. Synovial cysts also contain
gelatinous fluid and are lined with
cuboidal to somewhat flattened cells
consistent with a synovial origin. One
case of a ganglion cyst and one case of a
synovial cyst of the temporomandibular
joint are presented, and their
differential diagnosis and management are
discussed.
PMID: 9180226
Oral Surg Oral Med Oral Pathol. 1993
Oct;76(4):433-6.Links
Benign osteoblastoma associated with an
aneurysmal bone cyst of the mandibular
ramus and condyle.
Svensson B, Isacsson G.
Department of Oral and Maxillofacial
Surgery, Orebro Medical Center Hospital,
Sweden.
This article reviews the clinical
behavior, the histologic conditions, and
the treatment of a benign osteoblastoma
associated with an aneurysmal bone cyst of
the mandibular condyle and ramus. A
14-year-old boy, otherwise healthy, was
referred for pain and enlargement in his
right temporomandibular joint-cheek
region. The swelling was firm and tender,
a slight facial asymmetry was present, and
the mouth-opening capacity was reduced.
During a 6-weeks period from the primary
examination to surgery the lesion expanded
extensively, anesthesia appeared in the
right inferior alveolar nerve and a
lateral open bite developed on the
affected side. Computed tomography
displayed a total destruction of the right
mandibular condyle and ramus to the level
of the mandibular foramen. The lesion was
radiolucent without distinct borders to
adjacent bone. Surgery revealed a bluish,
well-vascularized predominantly cystic
tumor. The lesion included the
temporomandibular joint disk but without
overgrowth to the temporal component.
After resection of the lesion, the condyle
and the mandibular ramus was reconstructed
with the use of an autogenous
costochondral graft. The postoperative
healing was uncomplicated. At follow-up 2
years after surgery the boy was free of
recurrence with normal motor and sensory
nerve function.
PMID: 8233421
J Contemp Dent Pract. 2006 Jul
1;7(3)9-105.Click here to read Links
Temporomandibular joint clicking noises
caused by a multilocular bone cyst: a case
report.
Ozçelik TB, Ersoy AE.
University of Ankara, Faculty of
Dentistry, Turkey.
When diagnosing patients with
temporomandibular disorder (TMD) symptoms,
the possibility of unusual causes must be
considered, including neoplastic
disorders, as well as infections and
inflammatory disease. Therefore,
radiologic examination may prove to be
invaluable in the differential diagnosis
of TMDs. This article describes a patient
whose temporomandibular joint (TMJ) noise
was initially diagnosed by another dental
clinic as a TMJ anterior disc displacement
with reciprocal clicking. Occlusal splint
therapy was used for nearly three to four
months but did not improve the TMJ noise
condition. When the patient was examined
clinically and imaged with magnetic
resonance imaging (MRI) and computed
tomography (CT), a multilocular bone cyst
(MBC) was suspected. The cyst could cause
surface irregularities in the posterior
part of the left eminence of the temporal
bone, which could be the source of the
clicking noise.
J Oral Pathol Med. 2003
May;32(5):310-3.Links
Ganglion cyst of the temporomandibular
joint.
Kim SG, Cho BO, Lee YC, Hong SP, Chae CH.
Department of Oral and Maxillofacial
Surgery, Hallym University, Kyoungkido,
Korea.
We report a case of cystic lesion in a
37-year-old woman. The patient had an
oval-shaped lesion adjacent to the
temporomandibular joint. Thick fibrotic
tissue and muscle were observed
microscopically, but the epithelium lining
was not observed. The lesion was diagnosed
as a ganglion cyst. The patient's general
medical history was non-contributory. High
performance liquid chromatography (HPLC)
and mass spectrophotometry (MS) revealed
some proteins from the fluid in the
lesion, such as a filaggrin precursor,
dystroglycan, a polyprotein of the
hepatitis C virus, and proteins
originating from bacteria. The follow-up
examinations revealed no recurrence. The
probable pathogenesis of the lesion is
discussed.
PMID: 12694356
LAST EDITED ON May-05-08 AT 10:35 PM
(CST)
Ann Plast Surg. 1987
Apr;18(4):323-6.Links
Recognizing the temporomandibular joint
ganglion.
Kenney JG, Smoot EC, Morgan RF, Shapiro
D.
A case report of a cystic preauricular
mass that changed in size and position
with jaw movement is presented. This tumor
proved to be a ganglion of the
temporomandibular joint (TM) cyst, which
is relatively rare. When a preauricular
mass retrudes into the masseter muscle in
jaw opening, pathological conditions
associated with the TMJ should be
considered. Ganglion cysts of the TMJ are
a benign pathological entity which can
mimic parotid tumors. Temporomandibular
joint radiography and perhaps
ultrasonography of the region are useful
in the preoperative evaluation of
preauricular masses. The TMJ ganglion cyst
can be successfully treated by direct
excision and repair of the joint capsule.
This approach avoids the potential
morbidity of a superficial parotidectomy.
Main Articles
Temporomandibular joint capsule prolapse:
a technique of repair using autograft
cartilage
Shakeel R. Saeeda1 c1, Nadeem R. Saeeda2
and Gerald B. Brookesa1
a1 Royal National Throat, Nose and Ear
Hospital, Gray's Inn Road, London and
Department of Oral and Maxillofacial
Surgery
a2 Department of Oral and Maxillofacial
Surgery, The Royal London Hospital,
London.
Abstract
Loss of bony integrity of the
temporomandibular joint may result in
prolapse of the joint capsule into the
external auditory canal. This in turn
gives rise to arthralgia, trismus and
earache and a risk of septic arthritis.
We describe a technique of repair which is
simple, uses autologous tissue and has an
acceptable cosmetic and functional
result.
c1 Mr S. R. Saeed, University Department
of Otolaryngology, Manchester Royal
Infirmary, Oxford Road, Manchester M13
9WL.
Simple bone cyst of the mandibular
condyle with severe osteoarthritis: report
of a case
* Toshiyuki Ogasawara11Department of
Dentistry and Oral Surgery, medical answer
Medical University, Matsuoka, medical
answer, Japan
* Yoshimasa Kitagawa11Department of
Dentistry and Oral Surgery, medical answer
Medical University, Matsuoka, medical
answer, Japan,
* Toru Ogawa11Department of Dentistry and
Oral Surgery, medical answer Medical
University, Matsuoka, medical answer,
Japan,
* Tetsushi Yamada11Department of Dentistry
and Oral Surgery, medical answer Medical
University, Matsuoka, medical answer,
Japan,
* Sachiko Yamamoto11Department of
Dentistry and Oral Surgery, medical answer
Medical University, Matsuoka, medical
answer, Japan,
* Kaihei Hayashi11Department of Dentistry
and Oral Surgery, medical answer Medical
University, Matsuoka, medical answer,
Japan
*
1Department of Dentistry and Oral Surgery,
medical answer Medical University,
Matsuoka, medical answer, Japan
T. Ogasawara, Department of Dentistry and
Oral Surgery, medical answer Medical
University, 23 Shimoaizuki, Matsuoka,
medical answer, 910–1193, Japan
Abstract
A rare case of simple bone cyst in the
mandibular condyle of a 33-year-old woman
is reported. The condition was difficult
to diagnose because the cyst was
accompanied by severe osteoarthritis.
T1-weighted magnetic resonance (MR) images
revealed a cystic lesion with intermediate
signal intensity within the condylar head
and an irregular margin with intermediate
signal intensity on the superior surface
of the condyle. The patient was treated by
high condylectomy, discectomy and
reconstruction by sagittal split ramus
osteotomy. Histopathological examination
showed a simple bone cyst in the condylar
head and erosion of the anterior articular
surface due to degenerative changes.
simple bone cyst,
9) aneurysmal bone cyst, 10) epidermal
inclusion cyst, 11) hemangioma, 12)
nonossifying fibroma, 13) Langerhans cell
histiocytosis, 14) plasma cell myeloma,
15) sarcoma.
