Neurotologic Skull Base Access for Primary Tumors of the Temporomandibular Joint

Objectives: To familiarize the physician with the clinical and radiographic features associated with primary tumors of the temporomandibular joint (TMJ) and to demonstrate the use of the neurotologic skull base techniques in the surgical extirpation of TMJ tumors. Study Design: This was a retrospective chart review spanning the years 1988 to 2012. Setting: Tertiary care academic medical center. Patients: Any patient with diagnosis of a primary TMJ tumor who received surgical management at our institution. Intervention: The surgical approaches used included preauricular infratemporal fossa, postauricular infratemporal fossa, and pterional infratemporal fossa. Main Outcome Measures: The most critical assessment measures were postoperative patient morbidity and evidence of disease at follow-up visits. Results: The surgical approach was tailored according to the radiographic mapping of the size and location of the tumor. Trismus and jaw discomfort were the most common postoperative complications. Conductive hearing loss occurred only in patients who underwent oversewing of the cartilaginous ear canal. Conclusion: The presenting signs and symptoms of extremely rare primary TMJ tumors are those often seen by otolaryngologists. Contemporary neurotologic skull base surgical techniques can optimize the successful extirpation of these lesions.