北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (1): 43-47.

• 论著 • 上一篇    下一篇

颞下颌关节腱鞘囊肿和滑膜囊肿的诊断与治疗

孟娟红1,郭传瑸1,马绪臣2△   

  1. (北京大学口腔医学院·口腔医院 1. 口腔颌面外科, 2. 颞下颌关节病及口颌面痛诊治中心, 北京100081)
  • 出版日期:2014-02-18 发布日期:2014-02-18

Diagnosis and treatment of the ganglion cysts and synovial cysts arising from the temporomandibular joints

MENG Juan-hong1, GUO Chuan-bin1, MA Xu-chen2△   

  1. (1. Department of Oral and Maxillofacial Surgery, 2. Center for Temporomandibular Joint Disorder and Orofacial Pain, Peking University School and Hospital of Stomatology, Beijing 100081, China)
  • Online:2014-02-18 Published:2014-02-18

摘要: 目的:回顾性分析颞下颌关节腱鞘囊肿和滑膜囊肿的临床特点及治疗预后,为早期临床诊断和治疗提供参考。方法:收集1998年5月至2013年8月间在北京大学口腔医学院颞下颌关节病及口颌面痛诊治中心、口腔颌面外科就诊并进行治疗,最终诊断为颞下颌关节腱鞘囊肿和滑膜囊肿的患者9例,就其临床表现、影像学特点、诊断与鉴别诊断、治疗和随访情况进行总结和讨论。结果:9例患者中,男性3例,女性6例,年龄33~62岁,中位年龄39岁;病程2周至3年,中位值4个月。行普通X线检查者7例,CT检查者8例,MRI检查者6例,B超检查1例。最终诊断为腱鞘囊肿者7例,滑膜囊肿2例。腱鞘囊肿主要表现为耳前区或关节区的包块或膨隆,无明显症状或局部仅有酸胀不适感,偶然有痛;而滑膜囊肿则表现为耳前区肿痛、开口受限等,可伴咬合紊乱。行手术切除8例,关节穿刺冲洗治疗1例。随访时间3个月至9年,其中1例复发,其余8例无复发。结论:MRI检查对颞下颌关节腱鞘囊肿和滑膜囊肿的诊断和治疗有重要价值。手术切除治疗具有较好的治疗效果,但经关节腔穿刺冲洗治疗滑膜囊肿同样获得了良好的治疗效果,有待于更多病例治疗经验的积累。

关键词: 颞下颌关节, 腱鞘囊肿, 滑膜囊肿

Abstract: Objective:To give a reference for the early diagnosis and treatment of the cysts arising from the temporomandibular joint. Methods: Nine patients finally diagnosed as temporomandibular joint cysts at the Peking University Hospital of Stomatology from May 1998 to August 2013 were selected and reviewed. Their clinical manifestations, imaging features, diagnoses and differential diagnoses, treatments and followups were summarized and discussed. Results: In the 9 patients, 3 were males and 6 females. Their ages ranged from 33 to 62 years with a median age of 39 years; the course of the disease ranged from 2 weeks to 3 years with a median of  4 months. The image examinations were performed with conventional X-ray examinations in 7 cases, CT scans in 8 cases, MRI in 6 cases and ultrasound in one case. Of the 9 cases, 7 were finally diagnosed as ganglion cyst and 2 as synovial cyst. Ganglion cysts mainly presented as the mass of preauricular area or joint area, with no obvious symptoms or only local discomfort, occasionally with pain. The synovial cysts manifested as the painful swelling of preauricular area and limited mouthopening, accompanying with occlusal disorders. The treatments included surgical resection in 8 cases, repeated arthrocenteses and lavages in one case. The follow-ups were from 3 months to 9 years, one case with recurrence, and the remaining eight cases without recurrence. Conclusion: MRI examinations are very helpful in the early diagnosis and treatment planning of temporomandibular joint cysts. Surgical resection can have good results. Repeated arthrocenteses and lavages also have a good result, which may be an alternative choice for synovial cyst, but more accumulation of clinical experience is further needed.

Key words: Temporomandibular joint, Ganglion cyst, Synovial cyst

[1] 李红光,韩玮华,吴训,冯继玲,李刚,孟娟红. 关节腔冲洗联合液态浓缩生长因子注射治疗单侧颞下颌关节骨关节炎的初步研究[J]. 北京大学学报(医学版), 2024, 56(2): 338-344.
[2] 周境,刘怡. 不同垂直骨面型骨性Ⅱ类青少年女性颞下颌关节锥形束CT测量分析[J]. 北京大学学报(医学版), 2021, 53(1): 109-119.
[3] 韩玮华,罗海燕,郭传瑸,宁琦,孟娟红. 软骨寡聚基质蛋白在颞下颌关节滑膜软骨瘤病中的表达[J]. 北京大学学报(医学版), 2021, 53(1): 34-39.
[4] 陈硕,贺洋,安金刚,张益. 计算机辅助设计虚拟颌位在儿童颞下颌关节强直合并颌骨畸形同期矫治中的应用[J]. 北京大学学报(医学版), 2019, 51(5): 954-958.
[5] 李明哲,王晓霞,李自力,伊彪,梁成,何伟. 计算机导航辅助下口内入路髁突切除术精确性分析[J]. 北京大学学报(医学版), 2019, 51(1): 182-186.
[6] 王丹丹,甘业华,马绪臣,孟娟红. ADAMTS14基因单核苷酸多态性与汉族女性颞下颌关节骨关节炎的相关性研究[J]. 北京大学学报(医学版), 2018, 50(2): 279-283.
[7] 孟娟红,郭玉兴,罗海燕,郭传瑸,马绪臣. 颞下颌关节弥漫型腱鞘巨细胞瘤的诊断与治疗[J]. 北京大学学报(医学版), 2016, 48(6): 1049-1054.
[8] 雷杰,刘木清,傅开元. 睡眠问题、焦虑及压力是颞下颌关节紊乱病肌筋膜疼痛发病的风险指标[J]. 北京大学学报(医学版), 2016, 48(4): 692-696.
[9] 王志辉, 姜岚, 赵燕平, 马绪臣. 青少年颞下颌关节骨关节病锥形束CT分析[J]. 北京大学学报(医学版), 2013, 45(2): 280-.
[10] 孟娟红, 甘业华, 马绪臣. 颞下颌关节骨关节炎发病的分子机制及相关治疗的实验研究[J]. 北京大学学报(医学版), 2013, 45(1): 5-8.
[11] 王霄, 张益, 李江明. 髁突矢状骨折继发颞下颌关节强直动物模型的建立[J]. 北京大学学报(医学版), 2011, 43(6): 903-907.
[12] 曹烨, 李锴, 傅开元, 谢秋菲. 咬合干扰致大鼠咬肌组织蛋白基因产物及P物质表达变化[J]. 北京大学学报(医学版), 2010, 42(1): 50-55.
[13] 张豪, 赵燕平, 韩科, 马绪臣. 稳定(牙合)垫治疗对颞下颌关节腔内压力的影响[J]. 北京大学学报(医学版), 2008, 40(1): 68-70.
[14] 孙志鹏, 邹冰爽, 赵燕平, 马绪臣. 口腔正畸患者颞下颌关节骨关节病的临床分析[J]. 北京大学学报(医学版), 2008, 40(1): 47-51.
[15] 王瑞永, 马绪臣, 张万林, 柳登高. 健康成年人颞下颌关节间隙锥形束计算机体层摄影术测量分析[J]. 北京大学学报(医学版), 2007, 39(5): 503-506.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!