ABSTRACT
La displasia fibrosa (DF) es una enfermedad fibroósea benigna que consiste en el reemplazamiento de hueso normal con excesiva proliferación de tejido conectivo fibroso con estructuras óseas afuncionales. La forma de DF craneofacial es poco frecuente y no está bien definida. La afectación más frecuente en el área craneofacial se da en el cuerpo de la mandíbula y zona posterior del maxilar. Los autores describen el manejo completo y la rehabilitación funcional de un caso de displasia fibrosa de mandíbula avanzado y revisan las opciones terapéuticas de esta condición (AU)
Fibrous dysplasia (FD) is a benign fibro-osseous disease where normal bone is replaced by an excessive proliferation of fibrous connective tissue with irregular trabecular bone. Craniofacial involvement is uncommon and is not well defined. The most commonly involved bones in the craniofacial area are the mandible body and the posterior maxilla. The authors describe the complete management and functional rehabilitation of a case of advanced fibrous dysplasia of the mandible, and provide an updated review of the therapeutic options for this condition (AU)
Subject(s)
Humans , Female , Young Adult , Craniofacial Abnormalities/diagnosis , Fibrous Dysplasia of Bone/diagnosis , Mandible/abnormalities , Microsurgery/methods , Mandibular Reconstruction/methodsABSTRACT
PURPOSE: To report an exceptional case of bilateral synovial chondromatosis (SC) of the temporomandibular joint (TMJ) and discuss diagnostic approaches, treatment options and follow-up data. PATIENTS AND METHODS: A 38-year-old woman presented with left preauricular swelling. Initial imaging studies revealed TMJ effusion only. Six years later, synovial calcifications were detected in the left TMJ; the right TMJ space was widened and presented incipient calcium deposits. Open arthrotomy of the left TMJ was performed, with removal of multiple cartilaginous loose bodies and complete synovectomy. Periodic controls proved the asynchronic development of intra-articular bodies in the right TMJ. RESULTS: SC is a metaplastic arthropathy that is uncommon in the TMJ. Bilaterality is exceptional. Diagnosis is often delayed due to the non-specific symptoms, progressive developmental stages and clinicians' lack of awareness of the condition. Magnetic resonance imaging (MRI) is particularly helpful in defining disease extension, excluding a possible tumour and detecting internal derangement. Definitive diagnosis requires arthroscopic or open examination and histopathological analysis. Recurrences are infrequent after arthrotomy, removal of loose bodies and complete synovectomy. CONCLUSION: SC is an uncommon condition in the TMJ. Bilateral involvement is extremely rare. MRI is effective for diagnosis and postoperative follow-up. Complete synovectomy usually yields an excellent prognosis.
