PDF icon PDF herunterladen
Open Access
CC BY 4.0 · J Neurol Surg Rep 2025; 86(02): e127-e132
DOI: 10.1055/a-2620-3584
Original Report

Management of Rare Temporomandibular Joint Cysts with Intracranial Extension: A Case Series and Literature Review

Lindsey Jackson
1   Department of Otolaryngology—Head and Neck Surgery, University of Florida College of Medicine, Gainesville, Florida, United States
,
Jacob Poynter
1   Department of Otolaryngology—Head and Neck Surgery, University of Florida College of Medicine, Gainesville, Florida, United States
,
Maryam Rahman
2   Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida, United States
,
Tara Massini
3   Department of Radiology, University of Florida College of Medicine, Gainesville, Florida, United States
,
Si Chen
1   Department of Otolaryngology—Head and Neck Surgery, University of Florida College of Medicine, Gainesville, Florida, United States
› Institutsangaben
› Weitere Informationen
Auch verfügbar aufeRefMedOne
  Lizenzen und Reprints
Preview

Abstract

Introduction

Temporomandibular joint (TMJ) cysts extending through the skull base into the middle cranial fossa (MCF) are rare, with limited data on clinical progression and treatment. This study retrospectively analyzed three cases of TMJ cysts with MCF extension managed by a multidisciplinary team. Clinical presentation, imaging, surgical resection, outcomes, and a literature review are presented.

Case Presentations

Three patients presenting with otalgia and TMJ tenderness were found to have intracranial cysts communicating with the TMJ. Two patients had been transferred with suspected intracranial abscesses; one presented for workup of headache and trigeminal neuralgia. All three demonstrated elevation of inflammatory markers. Two patients had TMJ aspiration, notable for leukocytosis and crystalline deposition, another had frank purulence. One patient demonstrated pneumocephalus within the cyst on imaging. The intracranial cysts ranged from 1.2 to 3.3 cm in maximum diameter, with their bony defects ranging from <1 to 4 mm. Two patients underwent craniotomy, cyst resection, and repair of the middle fossa defect, while the third opted for observation. Pathology of the white gelatinous fluid within the two resected growths demonstrated benign cysts.

Conclusion

TMJ cysts with intracranial extension, while rare, require careful differentiation from intracranial abscesses. Surgical urgency may be indicated in cases demonstrating clinical signs of infection. Additionally, TMJ cysts with intracranial extension benefit from surgical removal and skull base repair to relieve symptoms and prevent future complications.

Keywords

temporomandibular joint - TMJ cyst - intracranial extension - intracranial abscess - middle cranial fossa - MCF defect

Previous Presentation

These data were presented at the 31st Annual Meeting of the North American Skull Base Society (February 18–20, 2022).




Publikationsverlauf

Eingereicht: 15. Februar 2025

Angenommen: 19. Mai 2025

Accepted Manuscript online:
26. Mai 2025

Artikel online veröffentlicht:
17. Juni 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany