J Korean Assoc Oral Maxillofac Surg.  2016 Aug;42(4):209-214. 10.5125/jkaoms.2016.42.4.209.

Bony window approach for a traumatic bone cyst on the mandibular condyle: a case report with long-term follow-up

• Kim HK
• Lim JH
• Jeon KJ
• Huh JK

• KMID: 2350073
• DOI: http://doi.org/10.5125/jkaoms.2016.42.4.209

Abstract

Traumatic bone cyst (TBC) occurs preferentially on the mandibular symphysis and body, but rarely on the mandibular condyle. When TBC occurs in the condylar area, it can usually be related with or misdiagnosed as a temporomandibular joint disorder. A 15-year-old female patient visited the Temporomandibular Joint Clinic with a 5-year history of pain and noise localized in the left temporomandibular joint. On imaging, a well demarked oval-shaped radiolucent lesion was observed on the left condyle head. The patient underwent cyst enucleation and repositioning of the bony window on the lateral cortex of the affected condyle head under the impression of subchondral cyst or TBC; however, no cystic membrane was found. The bone defect resolved and showed no recurrence on the serial radiographic postoperative follow-up for 43 months after surgery.

Keyword

Traumatic bone cyst; Simple bone cyst; Aneurysmal bone cyst; Mandibular condyle; Temporomandibular joint

MeSH Terms

Adolescent
Bone Cysts*
Female
Follow-Up Studies*
Head
Humans
Mandibular Condyle*
Membranes
Noise
Recurrence
Temporomandibular Joint
Temporomandibular Joint Disorders

Figure

• 

  Fig. 1 Panoramic view at the first visit. A well-defined radiolucent lesion with an irregular cortical surface of the condyle head (arrow) is observed on the left mandibular condyle.

• 

  Fig. 2 Preoperative computed tomography. Trabecular pattern is not detected in the bone marrow space of the left condyle head (arrows) on axial (A), coronal (B), or sagittal view (C).

• 

  Fig. 3 Preoperative sagittal T1-weighted (A) and sagittal (B) and coronal (C) T2-weighted magnetic resonance images of the left temporomandibular joint at closed mouth position. Bone marrow space of the condyle head shows high signal intensity (arrows).

• 

  Fig. 4 Operative findings. (A) The head of the left condyle (arrow) was exposed. (B) After creation of a bony window with an initial semicircular corticotomy. (C) Putting the bony wall aside, no cystic membrane was found in the cavity. (D) Repositioning of the bony wall (asterisk) just before closure.

• 

  Fig. 5 Serial evaluation of the left condylar cystic lesion (arrow) on the panoramic X-rays. Preoperative image (A), and images at 2 months (B), 5 months (C), 9 months (D), and 43 months (E) after surgery.

• 

  Fig. 6 Bony defect (arrowheads; A) in the left condyle head before surgery, and serial tomographic open-mouth images of the left condyle on panoramic X-ray. Images at 2 months (B), 5 months (C), 9 months (D), and 43 months (E) after surgery.

• 

  Fig. 7 Postoperative 43 months cone-beam computed tomography images. Normalized bony cavity without defect (arrows) on axial (A), coronal (B), and sagittal (C) views.

Reference

1. Kaugars GE, Cale AE. Traumatic bone cyst. Oral Surg Oral Med Oral Pathol. 1987; 63:318–324. PMID: 3473360.

2. Martins-Filho PR, Santos Tde S, Araújo VL, Santos JS, Andrade ES, Silva LC. Traumatic bone cyst of the mandible: a review of 26 cases. Braz J Otorhinolaryngol. 2012; 78:16–21. PMID: 22499365.

3. Forssell K, Forssell H, Happonen RP, Neva M. Simple bone cyst. Review of the literature and analysis of 23 cases. Int J Oral Maxillofac Surg. 1988; 17:21–24. PMID: 3127484.

4. An SY, Lee JS, Benavides E, Aminlari A, McDonald NJ, Edwards PC, et al. Multiple simple bone cysts of the jaws: review of the literature and report of three cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014; 117:e458–e469. PMID: 24842451.

5. Shigematsu H, Fujita K, Watanabe K. Atypical simple bone cyst of the mandible. A case report. Int J Oral Maxillofac Surg. 1994; 23:298–299. PMID: 7890974.

6. Oliveira DT, Hoshi AT, dos Reis OP. Clinical management of traumatic bone cyst in children: a case report. J Clin Pediatr Dent. 2000; 24:107–110. PMID: 11314316.

7. Beasley JD 3rd. Traumatic cyst of the jaws: report of 30 cases. J Am Dent Assoc. 1976; 92:145–152. PMID: 1060677.

8. Ogasawara T, Kitagawa Y, Ogawa T, Yamada T, Yamamoto S, Hayashi K. Simple bone cyst of the mandibular condyle with severe osteoarthritis: report of a case. J Oral Pathol Med. 1999; 28:377–380. PMID: 10478964.

9. Olech E, Sicher H, Weinmann JP. Traumatic mandibular bone cysts. Oral Surg Oral Med Oral Pathol. 1951; 4:1160–1172. PMID: 14882788.

10. Bechtel K, Soltis M. Traumatic bone cyst of the mandible in a 10-year-old boy. Pediatr Emerg Care. 2009; 25:96–97. PMID: 19225375.

11. Dincer O, Kose TE, Cankaya AB, Aybar B. Traumatic bone cyst mimicking radicular cyst. BMJ Case Rep. 2012; DOI: 10.1136/bcr-2012-007316.

12. Tanaka H, Westesson PL, Emmings FG, Marashi AH. Simple bone cyst of the mandibular condyle: report a case. J Oral Maxillofac Surg. 1996; 54:1454–1458. PMID: 8957127.

13. Magliocca KR, Edwards SP, Helman JI. Traumatic bone cyst of the condylar region: report of 2 cases. J Oral Maxillofac Surg. 2007; 65:1247–1250. PMID: 17517316.

14. Hatakeyama D, Tamaoki N, Iida K, Yonemoto K, Kato K, Makita H, et al. Simple bone cyst of the mandibular condyle in a child: report of a case. J Oral Maxillofac Surg. 2012; 70:2118–2123. PMID: 22248797.

15. Saia G, Fusetti S, Emanuelli E, Ferronato G, Procopio O. Intraoral endoscopic enucleation of a solitary bone cyst of the mandibular condyle. Int J Oral Maxillofac Surg. 2012; 41:317–320. PMID: 22024140.

16. Huang TL, Ghosh L, Barmada R. Subchondral cyst of bone: a case report. Clin Orthop Relat Res. 1979; (144):212–214. PMID: 535226.