Case Report

Clinical Image: Tophaceous Pseudogout of the Temporomandibular Joint

Shogo Shinohara1*, Toshihiko Takenobu2, Kazuya Kataoka3, Mika Ikeda3 and Hiroyuki Harada2
1Department of Otolaryngology – Head and Neck Surgery, Kobe City Medical Center General Hospital, Japan
2Department of Dentistry, Kobe City Medical Center General Hospital, Japan
3Department of Plastic Surgery, Kobe City Medical Center General Hospital, Japan


*Corresponding author: Shogo Shinohara, Department of Otolaryngology – Head and Neck Surgery, Kobe City Medical Center General Hospital, 2-1-1 MinatojimaMinamimachi, Chuo-ku, Kobe 650- 0047, Japan


Published: 28 Feb, 2017
Cite this article as: Shinohara S, Takenobu T, Kataoka K, Ikeda M, Harada H. Clinical Image: Tophaceous pseudogout of the Temporomandibular Joint. Ann Clin Otolaryngol. 2017; 2(2): 1012.

Clinical Image

Tophaceouspseudogout is a benign arthropathy that caused by the deposition of Calcium Pyrophosphatedehydrate Crystals (CPPD), which sometimes involves the temporomandibular joint. A 70-years-old female complained of a right preauricular mass and the occlusion insufficiency. In an axial CT image, calcium substances surrounding the mandibular condyle head occupied the infratemporal fossa close to foramen ovale (Figure 1A). A coronal CT image also revealed calcium substances existed between the condyle head and mandibular fossa, which suggested these calcium substances arose in the joint space (Figure 1B). Before the operation, a biopsy was made to prove the existence of CPPD crystals. The debulking of CPPD crystals performed under zygomatic approach. Enlarged capsule was incised and CPPD crystals were removed using endoscopy without damaging the articular disc. After the operation, herocclusion improved and CT images showed the elimination of the majority of the mass in the infratemporal fossa (Figure 2).


Figure 1

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Figure 1
Preoperative CT images (A. axial view, B. coronal view).

Figure 2

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Figure 2
Postoperative CT images (A. axial view, B. coronal view).