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Temporomandibular joints (TMJ)
Region of interest
Rt TMJ - coronal notch
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1. Osteoma at right coronoid notch
A pedunculated radiopaque mass with a lobulated shape is developing along the right coronoid notch. The most likely diagnosis is an osteoma. The radiographic features that support this diagnosis are the internal structure composed of granular cortical bone, the sessile shape, and the epicenter of formation outside of the contour of the normal cortical bone. This osteoma extends medially to the infratemporal fossa, but has not had any effect on the surrounding structures in this area. The right coronoid process and mandibular condyle appear normal. This osteoma should be monitored for continued growth.
Axial views of the osteoma
These axial cross-sectional images demonstrate the continuity of the osteoma with the medial cortex of the coronoid notch and its extension into the infra-temporal fossa. Note that the internal structure of the entity is composed of granular compact bone.
Sagittal views of the right coronoid notch
These sagittal cross-sectional images demonstrate the continuity of the osteoma with the cortical bone at the medial aspect of the coronoid notch and its extension into the infratemporal space. Note the surrounding structures appear intact. The temporal bone appears normal and has not been affected by the osteoma. .
Coronal views of the right coronoid notch
These coronal cross-sectional images demonstrate a normal appearance of the cortical and trabecular bone within the right condylar neck and coronoid process adjacent to the osteoma which is developing on the coronoid notch. Note the medial extension of the osteoma into the right temporal fossa. There is no evidence of erosion on the temporal bone at this region.
Orthogonal views of the osteoma
These orthogonal cross-sectional images demonstrate the approximate mesiodistal, buccolingual, and coronoapical dimensions of the osteoma in the right coronoid notch.
Normal left TMJ in mandibular closed position
In the mandibular closed position, the left condylar head is centrally positioned in the glenoid fossa. No signs of osseous degeneration are radiographically evident. The left temporomandibular joint appears normal radiographically. The osteoma has not had any effect on the right temporomandibular joint.
Reconstructed panoramic image from CBCT data
This reconstructed panoramic image demonstrates the normal coronoid processes and condylar heads bilaterally. The teeth are in maximum occlusion. The osteoma, which is growing within the right coronoid notch is noted.
2. Calcified stylohyoid ligaments
The stylohyoid ligaments are partially calcified bilaterally. This is an incidental finding with no clinical significance.
3. Extension of the sphenoid sinus
The sphenoid sinus extends to the roof of the left pterygoid plates. This is a non-significant incidental finding.