Publication:

Temporomandibular joint arthroplasty with tragal cartilage graft in the excision of a ganglion cyst herniating into the external auditory canal: a case report

Ganglion cysts of the temporomandibular joint (TMJ) are rare, and extension into the external auditory canal (EAC) is uncommon. These lesions may present with otologic symptoms such as aural fullness, conductive hearing loss, and visible protrusion into the canal. We present the case of a 63-year-old man with a 24-month history of preauricular pain, aural fullness, and conductive hearing loss. Clinical examination and otoscopy revealed a translucent mass obstructing more than 50% of the left EAC. Imaging demonstrated a 6 mm bony defect of the anterior EAC wall communicating with the TMJ. Surgical excision was performed through a preauricular approach, followed by reconstruction of the defect with an autogenous tragal cartilage graft. Histopathology confirmed a benign ganglion cyst. Postoperatively, the patient achieved complete resolution of symptoms and normal mandibular function, with no recurrence at 1-year follow-up. TMJ ganglion cysts with EAC extension are rare but should be considered in the differential diagnosis of EAC masses. Reconstruction with autogenous tragal cartilage provides effective anatomical restoration and symptom resolution.