Craniofacial Osteomas: From Diagnosis to Therapy

An osteoma is a benign bone lesion with no clear pathogenesis, almost exclusive to the craniofacial area. Osteomas show very slow continuous growth, even in adulthood, unlike other bony lesions. Since these lesions are frequently asymptomatic, the diagnosis is usually made by plain radiography or by a computed tomography (CT) scan performed for other reasons. Rarely, the extensive growth could determine aesthetic or functional problems that vary according to different locations. Radiographically, osteomas appear as radiopaque lesions similar to bone cortex, and may determine bone expansion. Cone beam CT is the optimal imaging modality for assessing the relationship between osteomas and adjacent structures, and for surgical planning. The differential diagnosis includes several inflammatory and tumoral pathologies, but the typical craniofacial location may aid in the diagnosis. Due to the benign nature of osteomas, surgical treatment is limited to symptomatic lesions. Radical surgical resection is the gold standard therapy; it is based on a minimally invasive surgical approach with the aim of achieving an optimal cosmetic result. Reconstructive surgery for an osteoma is quite infrequent and reserved for patients with large central osteomas, such as big mandibular or maxillary lesions. In this regard, computer-assisted surgery guarantees better outcomes, providing the possibility of preoperative simulation of demolitive and reconstructive surgery.

Temporomandibular Joint Disorders: A Pictorial Review

Temporomandibular joint (TMJ) disorders are commonly encountered in the general population but often ignored or unrecognized. The detection and characterization of lesions has drastically improved over the years due to technological advances in cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). However, adequate knowledge of the normal imaging appearance on different imaging modalities as well as the broad variety of pathology is required to provide a proper radiologic assessment. This pictorial review focuses on TMJ pathology and its appearance on CBCT and MRI. A short overview of the technical aspects and normal anatomy are provided to round out this complete summary on the subject.

Mandibular Condyle Osteoma

Background:

Osteoma is a benign tumor composed of both cortical and cancellous bones that increase in size with continuous formation of bone. The pathogenesis is unknown. Osteomas can cause symptoms depending on their location and size. They can be asymptomatic or symptomatic, with trismus, limitation of mouth opening, and progressive malocclusion with facial asymmetry and can be painful.

Aim:

The aim of this paper is to report an unusual case of osteoma in the mandibular condylar neck and review the cases of mandibular condyle osteomas that have been reported in the last 15 years.

Conclusions:

Only a few cases involving the temporomandibular joint have been reported. We report an unusual case of osteoma in the mandibular condylar neck causing restricted mouth opening in addition to pain. Complete surgical excision in symptomatic cases is the therapy of choice with a low recurrence rate.