N 6 (197) 2025. P. 93–98

SYNERGISM OF CLINICAL MANIFESTATIONS OF TEMPOROMANDIBULAR JOINT DYSFUNCTION AND MENINGIOMA. DIAGNOSTIC AND THERAPEUTIC CHALLENGES

M. A. Korostashova, K. A. Tarianyk, A. I. Pankevych, A. M. Hohol,
I. A. Kolisnyk, V. M. Novikov

Poltava State Medical University, Poltava, Ukraine

DOI 10.32782/2226-2008-2025-6-14

The aim of the study is to demonstrate the complexity of differential diagnosis and the need for a multidisciplinary approach for accurate identification of pathology and selection of effective treatment tactics. A clinical case of an atypical course of temporomandibular joint dysfunction in patients with a meningioma, the manifestations of which overlapped with the symptoms of the underlying disease, is described.

Materials and methods. A multidisciplinary approach was applied in managing the patient with atypical facial pain, involving gnathologists, neurologists, epileptologist and neurosurgeons.

Results. Temporomandibular joint dysfunction (TMD) is commonly associated with occlusal, muscular, and psycho-emotional factors.

However, in some cases, it may indicate concomitant pathologies.

A female patient with persistent temporomandibular pain initially experienced symptom relief with splint therapy. However, the pain recurred despite ongoing treatment. Additional neurological evaluation and MRI revealed the presence of a meningioma. The patient underwent surgical tumor removal. Following meningioma resection, the patient’s TMD symptoms completely resolved, suggesting a secondary origin of the dysfunction. This case underlines the complex and multifactorial nature of TMD and the necessity of differential diagnosis in persistent or atypical cases. TMD can sometimes be an early sign of severe neurological conditions. This case emphasizes the importance of interdisciplinary collaboration between dentists, neurologists, and radiologists in cases of chronic or treatment-resistant temporomandibular disorders. Early diagnosis of concomitant conditions can significantly improve patient outcomes.

Key words: temporomandibular joint dysfunction, meningioma, clinical case.

REFERENCES

  1. Garrigós-Pedrón M, Elizagaray-García I, Domínguez-Gordillo AA, Del-Castillo-Pardo-de-Vera JL, Gil-Martínez Temporomandibular disorders: improving outcomes using a multidisciplinary approach. J Multidiscip Healthc. 2019 Sep 3;12:733–747. doi: 10.2147/JMDH.S178507.
  2. Stepan L, Shaw CL, Oue S. Temporomandibular disorder in otolaryngology: systematic review. J Laryngol Otol. 2017;131(S1):S50–S56. doi: 10.1017/S0022215116009191.
  3. Jaber M, Khalid A, Gamal A, Faisal R, Mathew A, Ingafou M. A comparative study of condylar bone pathology in patients with and without temporomandibular joint disorders using orthopantomography. J Clin Med. 2023 Sep 6;12(18):5802. doi: 10.3390/jcm12185802.
  4. Boiko DI, Skrypnikov AM, Shkodina AD, Hasan MM, Ashraf GM, Rahman MH. Circadian rhythm disorder and anxiety as mental health complications in post-COVID-19. Environ Sci Pollut Res Int. 2022;29(19):28062–28069. doi: 10.1007/ s11356-021-18384-4.
  5. Boiko DI, Shkodina AD, Hasan MM, et al. Melatonergic receptors (Mt1/Mt2) as a potential additional target of novel drugs for depression. Neurochem Res. 2022;47(10):2909–2924. doi:10.1007/s11064-022-03646-5.
  6. Yelins’ka AM, Akimov OY, Kostenko VO. Role of AP-1 transcriptional factor in development of oxidative and nitrosative stress in periodontal tissues during systemic inflammatory response. Ukr Biochem J. 2019;91(1):80–85. doi: 10.15407/ ubj91.01.080.
  7. Pihut M, Gorecka M, Ceranowicz P, Wieckiewicz M. The efficiency of anterior repositioning splints in the management of pain related to temporomandibular joint disc displacement with reduction. Pain Res Manag. 2018 Feb 21;2018:9089286. doi: 10.1155/2018/9089286.
  8. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. doi: 10.1001/jama.2013.281053.
  9. Zeng L, Liang P, Jiao J, Chen J, Lei T. Will an Asymptomatic Meningioma Grow or Not Grow? A Meta-analysis. J Neurol Surg A Cent Eur Neurosurg. 2015;76(5):341–347. doi: 10.1055/s-0034-1543959.
  10. Konakh VM, Komarova TM. Features of destructive and inflammatory processes of the anterior surface of the eye in patients after removal of cerebellopontine angle tumors. Odesa Medical Journal. 2024;5(190)46–50. (In Ukrainian). doi: 10.32782/2226-2008-2024-4-8.
  11. Rogers L, Barani I, Chamberlain M, et al. Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review. J Neurosurg. 2015;122(1):4–23. doi: 10.3171/2014.7.JNS131644.
  12. Sanai N, Polley MY, Berger MS. Insular glioma resection: assessment of patient morbidity, survival, and tumor progression. J Neurosurg. 2010;112(1):1–9. doi: 10.3171/2009.6.JNS0952.
  13. Alruwaili AA, De Jesus O. Meningioma. [Updated 2023 Aug 23]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560538/.
  14. Har-El G, Calderon S, Sandbank J. Angioblastic meningioma presenting as a pain in the temporomandibular joint. J Oral Maxillofac Surg. 1987;45(4):338–340. doi: 10.1016/0278-2391(87)90356-9.
  15. Koumoura F, Contoes N. Meningioma manifested as temporomandibular joint disorder: a case report. Int Dent J. 2000;50(2):109–111. doi: 10.1002/j.1875-595x.2000.tb00808.x.
  16. Chukiattiman K. The Temporomandibular Joint Disorder (TMD) with atypical odontalgia as the consequence of the intracranial tumor: a case report. Region 11 Medical Journal. 2019;33(3):529–540. (In Thai). Available from: https://he02.tci-thaijo.org/index.php/Reg11MedJ/article/view/216966.
  17. Englot DJ, Magill ST, Han SJ, Chang EF, Berger MS, McDermott MW. Seizures in supratentorial meningioma: a systematic review and meta-analysis. J Neurosurg. 2016;124(6):1552–1561. doi: 10.3171/2015.4.JNS142742.
  18. Kalladka M, Al Obaidi N, Babu LKT, Maloth S, Khan J. Medial sphenoid wing parasellar meningioma masquerading as temporomandibular joint disorder: A case report. J Am Dent Assoc. 2020;151(3):210–215. doi:10.1016/j.adaj.2020.01.016.
  19. Minervini G, Marrapodi MM, Siurkel Y, Cicciù M, Ronsivalle V. Accuracy of temporomandibular disorders diagnosis evaluated through the diagnostic criteria for temporomandibular disorder (DC/TDM) Axis II compared to the Axis I evaluations: a systematic review and meta-analysis. BMC Oral Health. 2024;24(1):299. doi: 10.1186/s12903-024-03983-7.
  20. Vyzhenko Y, Kuroiedova V, Vyzhenko H, Makarova O, Stasiuk O. The relationship between malocclusion and craniofacial profile pathology. Eastern Ukrainian Medical Journal. 2025;13(1):274–284. doi: 10.21272/eumj.2025;13(1):274-284.
View article PDF