title: Update on the surgical management of temporomandibular joint-centered tendon sheath giant cell tumor with intradural extension: introducing a cost-effective method in using temporal bone for skull base reconstruction in preventing brain hernia.
abstract: Tendon sheath giant cell tumor is an idiopathic proliferative and destructive disease of the synovium. It is rare and tends to arise in large joints, for example, knee and ankle, but it can also arise in temporomandibular joints (TMJs). Because of its destructive nature, immediate treatment upon diagnosis is recommended. Radical resection proved to be an excellent choice for superior local control. However, the unfavorable anatomic location of TMJ and infratemporal fossa tumor with intradural extension make such a resection impractical. Hereby, we reported a case of resection of a TMJ tendon sheath giant cell tumor with intradural extension using a transcranial approach. This involves a complex radical resection with subsequent reconstruction. Transposition of temporal bone flap is a novel state-of-the-art technique in reconstructing the middle fossa floor defect by providing a three-dimensional rigid architecture to support the brain. Temporal bone flap is a reliable plug for rigid support in preventing brain hernia and cerebrospinal fluid leak. Despite its complexity, this cost-effective technique is relatively straightforward to learn and is applicable across all socioeconomic groups.
authors: From the Departments of *Oral and Maxillofacial Surgery-Head & Neck Oncology and †Neurosurgery, Ninth People's Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Head and Neck Cancer Centre, Shanghai, China.
authors: Hui Shan
authors: HS
authors: Ong
authors: Chen Ping
authors: CP
authors: Zhang
authors: Yi Qun
authors: YQ
authors: Wu
authors: Tong
authors: T
authors: Ji
mesh_terms: D016025:Bone Transplantation / Q000379:methods*; D001930:Brain Injuries / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D004388:Dura Mater / Q000473:pathology; D005870:Giant Cell Tumors / Q000601:surgery*; D006547:Hernia / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D019292:Skull Base Neoplasms / Q000601:surgery*; D013524:Surgical Flaps; D013701:Temporal Bone / Q000637:transplantation*; D013704:Temporomandibular Joint / Q000601:surgery*; D013710:Tendons / Q000473:pathology / Q000601:surgery