顔面非対称を伴った顎関節滑膜性骨軟骨腫症に対して下顎枝垂直骨切り術を応用した１症例

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  • A Case of Synovial Chondromatosis of the Temporomandibular Joint with Facial Asymmetry using an Intraoral Vertical Ramus Osteotomy

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Synovial chondromatosis is a disease of cartilagenous metaplasia of the synovial membrane accompanied with loose bodies within the articular cavity. It occurs frequently in the knee, elbow, and hip joints. However, reports of this lesion of the temporomandibular joint (TMJ) are rare.<BR>A 21-year-old woman visited our hospital complaining of facial asymmetry, malocclusion, and a clicking sound in the left TMJ region. Her purpose was to undergo treatment of orthognathic surgery. But panoramic radiography, 3D-CT, and MRI revealed calcified loose bodies surrounding the condyle of the left TMJ.<BR>After an intraoral vertical left ramus osteotomy was performed (IVRO), removal of all loose bodies, a synovectomy and a discectomy were performed, using the Al-Kayat-Bramley technique. The loose bodies totaled 88 white nodules measuring 3 to 7mm in diameter. Histological examination of the loose bodies demonstrated cartilagenous metaplasia. Using this technique, this patient was made free from disease and functional disturbances of the TMJ, and at the same time she had an improved facial and occlusal form after surgery.

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