Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review

World Journal of Surgical Oncology

Research

Bongju Kim¹  Hye-Jung Yoon²  Kyung-Hoe Huh³  Ik-Jae Kwon⁴  Soung Min Kim⁴  Hyun Jun Oh⁵  Joo Yong Park⁵  Sung Weon Choi⁵  Jong-Ho Lee⁶ 

[1] Dental Life Science Research Institute, Innovation Research & Support Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea;Department of Oral Pathology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea;Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea;Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea;Oral Oncology Clinic, National Cancer Center, Goyang, Korea;Oral Oncology Clinic, National Cancer Center, Goyang, Korea;Dental Life Science Research Institute, Innovation Research & Support Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea;

关键词: Chondrosarcoma;    Temporomandibular joint;    TMJ reconstruction;    Facial nerve transection;    Nerve graft;   

DOI  :  10.1186/s12957-023-03143-1

 received in 2023-02-25, accepted in 2023-08-08,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSurgical management for chondrosarcoma of the temporomandibular joint (TMJ) is challenging due to the anatomical location involving the facial nerve and the functional joint. The purpose of this case series was to analyze the largest number of TMJ chondrosarcoma cases reported from a single institution and to review the literature about chondrosarcoma involving the TMJ.MethodsTen TMJ chondrosarcoma patients at Seoul National University Dental Hospital were included in this study. Radiographic features, surgical approaches, histopathologic subtypes, and treatment modalities were evaluated. All case reports of TMJ chondrosarcoma published in English from 1954 to 2021 were collected under PRISMA guidelines and comprehensively reviewed.ResultsThe lesions were surgically resected in all 10 patients with efforts to preserve facial nerve function. Wide excision including margins of normal tissue was performed to ensure adequate resection margins. All TMJs were reconstructed with a metal condyle except one, which was reconstructed with vascularized costal bone. At last follow-up, all patients were still alive, and there had been no recurrence. Among 47 cases (patients from the literature and our cases), recurrence was specified in 43 and occurred in four (9.5%).ConclusionsFor surgical management of TMJ chondrosarcoma, wide excision must consider preservation of the facial nerve. Reconstruction using a metal condyle prosthesis and a vascularized free flap is reliable. A more conservative surgical approach correlates with a favorable prognosis for facial nerve recovery. Nevertheless, wide excision is imperative to prevent tumor recurrence. In cases in which the glenoid fossa is unaffected by the tumor, it is deemed unnecessary to reconstruct the glenoid fossa within an oncological setting.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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