颞下颌关节滑膜软骨瘤病3例临床分析  

Clinical Analysis of Synovial Chondromatosis in the Temporomandibular Joint:Report of Three Cases

作　　者：韩前超[1] 向国林[1] 蔡恒星[2] 邓末宏[2] 

机构地区：[1]华中科技大学同济医学院附属普爱医院口腔科,湖北武汉430034 [2]武汉大学口腔医学院口腔颌面外科

出　　处：《口腔医学研究》2012年第5期450-452,456,共4页Journal of Oral Science Research

摘　　要：目的:探讨颞下颌关节滑膜软骨瘤病的临床特点。方法:报告3例(3侧)颞下颌关节滑膜软骨瘤病,对其临床表现、影像、诊断及治疗进行分析。结果:3例患者均有关节区疼痛(3/3),2例开口受限(2/3),1例关节区肿胀(1/3)。3例X线平片均见关节间隙增宽(3/3),2例关节造影发现关节内占位性改变(2/3),1例CT显示颅底骨质破坏(1/2),1例MRI发现关节腔积液和游离体(1/1),关节镜检查可早期诊断本病(3/3)。3例患者均行开放性关节手术。结论:颞下颌关节滑膜软骨瘤病临床上罕见,无特征性临床表现,好发于关节上腔。需结合影像学、关节镜和病理学进行诊断,游离体是最重要的特征。本病需手术治疗,常用手术方法为关节切开后行游离体和受累滑膜切除。Objective： To discuss the clinical characteristics of synovial chondromatosis of the temporomandibular joint （TMJ）. Methods： Three patients （3 joints） with synovial chondromatosis of the TMJ were reported. The clin- ical manifestation,imagining findings, diagnosis and therapy of these patients were analyzed retrospectively. Re- suits： These patients presented pain （3/3）, swelling （1/3）and limitation of mouth opening （2/3）. Conventional ra- diograph showed widening of the joint space （3/3）, arthrography found the mass in the joint space additionally （2/3） ,CT indicated destruction of the basion bone （1/2）, MRI revealed a large amount of synovial fluid and loose bodies within the joint cavity（I/l）, and arthroscope were helpful for early diagnosis （3/3）. Open arthrotomy was performed for treatment. Conclusion： Synovial chondromatosis of TMJ is extremely rare and has nonspecific clinical features. The lesion mainly affects the superior joint cavity. The definitive diagnosis can only be made on the basis of imagining findings, arthroscope and histopathology, especially the findings of loose bodies within the joint cavity. Open arthrotomy is recommended for the treatment, with removal of loose bodies and of the involved synovial mere brane.

关 键 词：滑膜软骨瘤病 颞下颌关节 临床表现诊断 治疗 

分 类 号：R739.8[医药卫生—肿瘤]