External Auditory Canal Stenosis Secondary to Synovial Chondromatosis of the Temporomandibular Joint: A Case Report and Literature Review

Key findings from this study

This research indicates that:

• Synovial chondromatosis of the temporomandibular joint can secondarily cause external auditory canal stenosis through lesion expansion and invasion of adjacent structures.
• Atypical presentations featuring inferior joint space predominance occur and may differ substantially from classical superior joint space involvement.
• Combined open and endoscopically assisted surgery improves visualization during resection of lesions involving the medial condylar pole and allows more complete excision.

Overview

Synovial chondromatosis of the temporomandibular joint is a rare, slow-growing neoplastic condition presenting diagnostic challenges due to nonspecific clinical manifestations. This case represents the first documented occurrence of synovial chondromatosis causing external auditory canal stenosis. The lesion demonstrated atypical inferior joint space predominance, contrasting with the typical superior joint space involvement reported in prior literature.

Methods and approach

The authors reviewed clinical presentation, imaging findings, and surgical management of a patient with synovial chondromatosis of the temporomandibular joint complicated by external auditory canal stenosis. Open temporomandibular joint surgery with endoscopic assistance was selected to optimize visualization of the medial pole of the condyle. This combined approach facilitated complete lesion resection while managing the adjacent structural involvement.

Results

The patient presented with external auditory canal stenosis secondary to expansion of the temporomandibular joint lesion. Imaging and intraoperative findings confirmed synovial chondromatosis with predominant inferior joint space involvement. The combined open and endoscopically assisted surgical approach achieved complete resection of the lesion while preserving temporomandibular joint function.

This case demonstrates that synovial chondromatosis can manifest atypically with invasion of adjacent anatomical structures beyond the joint capsule. The inferior joint space involvement, rather than the classically described superior space pattern, represented a departure from typical disease presentation. Advanced disease stages necessitate multimodal surgical strategies to address both the primary lesion and secondary complications affecting neighboring structures.

Implications

Early recognition of synovial chondromatosis remains clinically critical given the rarity of the condition and nonspecific symptomatology that delays diagnosis. Clinicians evaluating external auditory canal stenosis should include temporomandibular joint pathology in the differential diagnosis, particularly when conventional otologic etiologies are excluded. The case reinforces the importance of comprehensive imaging evaluation to detect disease extension beyond the joint capsule.

Surgical management of advanced synovial chondromatosis with structural invasion requires tailored approaches that balance lesion resection completeness with functional preservation. Combined open and endoscopic techniques enhance intraoperative visualization of complex anatomical regions. This integrated surgical strategy may prove advantageous in cases exhibiting atypical disease patterns or extensive adjacent structure involvement.

Scope and limitations

This summary is based on the study abstract and available metadata. It does not include a full analysis of the complete paper, supplementary materials, or underlying datasets unless explicitly stated. Findings should be interpreted in the context of the original publication.