Dislocation of a fractured mandibular condyle into the middle cranial fossa: a case treated by an extracranial approach.

INTRODUCTION: Penetration of the mandibular condyle into the middle cranial fossa is a rare complication usually due to blunt traumas to the chin. Particular anatomical and dynamic conditions can lead to the intracranial dislocation of the condyle in spite of the fracture of the condylar neck that usually prevents this event from dissipating the kinetic force of the impact. DISCUSSION: We report the case of a 10-year-old female patient suffering from symphyseal and bilateral condilar fracture with intrusion of the left condyle into the middle cranial fossa. The diagnosis of intracranial dislocation was initially missed because of the nonspecific symptomatology and insufficient radiologic data provided by conventional investigations (plain X-rays and panoramic views). The persistence of the limitation of the mouth opening and the worsening of the preauricular pain with irradiation to the temporal region led us to perform further radiological investigations (computed tomography scan and magnetic resonance imaging) that revealed the intracranial complication. A successful removal of the displaced condyle was carried out through an extracranial approach, and at a 3-year follow-up temporomandibular joint function is satisfactory. CONCLUSION: The case is reported to emphasize the need for careful radiological investigation in case of condylar fractures and the effectiveness of the extracranial route to surgically treat these rare complications.

Glomangiopericytoma of the pterygomandibular space: an unusual case.

We describe a case of glomangiopericytoma located in the pterygo-mandibular space, a rare anatomical region for this neoplasm to develop. The lesion is classified as a separate variant from the classic haemangiopericytoma, which is characterised by more aggressive biological behaviour.

[Radiopaque lesions of the jaws]. / Le lesioni osteoaddensanti dei mascellari.

This paper provides an overview of radiopaque lesions of the jaws after having outlined the various criteria for classification; depending on their etiology. Those lesions are generally separated into lesions with an unknown cause and lesions with a known etiology (phlogistic, dysplastic-dystrophic, tumoral). The authors give a general description of the clinical and radiographic symptoms of the main lesions. In many cases, with the exception of asymptomatic lesions with an unknown etiology, the patient presents a variable swelling that deforms the bone in question, resulting in asymmetry of the face and/or, depending on the site, nasal obstruction, mastication and speech disorders, exophthalmos with or without diplopia. The radiographic aspect of lesions and the associated laboratory and clinical findings often enable a diagnosis to be reached, but in doubtful cases diagnosis can only be confirmed by histological analysis.