颞下颌关节滑膜软骨瘤病的临床分析  

Synovial chondromatosis in the temporomandibular joint: analysis of 5 cases

作　　者：贾搏 褚洪星[1] 韩久松[1] 孙翔[1] 王治平[1] 周会喜[1] 

机构地区：[1]南方医科大学口腔医院(广东省口腔医院)口腔颌面外科,广东广州510280

出　　处：《南方医科大学学报》2017年第6期858-860,F0003,共4页Journal of Southern Medical University

基　　金：广东省科技计划项目(2014A020212549)

摘　　要：本研究收集2011年8月~2014年8月间于我院诊治的颞下颌关节滑膜软骨瘤病患者5例,所有患者术前影像学检查协助临床诊断和病灶范围,对收集的病例采取手术治疗方案,术后经病理诊断均明确为滑膜软骨瘤病。分析其临床表现、影像特征、诊断及治疗结果,5例患者均有关节区疼痛的症状,其中3例开口受限、3例关节区肿胀、5例患者X线平片见关节间隙增宽、5例影像学检查发现有关节内占位性改变。采取开放性关节手术方案,所有手术顺利完成,术后影像学检查显示术区无病灶残留。关于颞下颌关节滑膜软骨瘤病在临床上的研究极为罕见,文献报道极少,临床表现并不明显,在诊断过程中常常需结合影像学、关节镜和病理学等检查,其中游离体是该疾病的重要特征,且多发于关节上腔。颞下颌关节滑膜软骨瘤病需行手术治疗,临床常用手术方案为关节切开后行游离体和受累滑膜切除术。Five patients with synovial chondromatosis in the temporomandibular joint were treated in our hospital between August, 2011 and August, 2014. All the patients underwent preoperative imaging examinations for clinical diagnosis and determining the involvement of the lesions. Surgeries were performed and the lesions were confirmed as synovial chondromatosis by pathological diagnosis. The clinical manifestations, imaging features, diagnosis and treatment results were analyzed. All the 5 patients had pain in the joint region, 3 had limited mouth opening, and 3 had swelling in the joint region. X-ray film showed widening of the joint space in all the 5 cases and radiographic findings showed space-occupying lesions in the intra-articular space. Open joint surgeries was performed and completed successfully in all the cases. The postoperative imaging showed no residual lesions in the surgical area. As a rare clinical entity, synovial chondromatosis in the temporomandibular joint was poorly documented without specific clinical manifestations. The diagnosis of synovial chondromatosis relies on imaging, arthroscopic and pathological findings. Corpus liberum is an important feature of the disease occurring frequently in the joint cavity. Surgical intervention is the primary choice for treatment of synovial chondromatosis in the temporomandibular joint, in which the corpus liberum and the affected synovial membrane shall be removed after joint incision.

关 键 词：滑膜软骨瘤病 颞下颌关节 临床表现 临床诊断 游离体和受累滑膜切除术 

分 类 号：R739.8[医药卫生—肿瘤]