|LETTER TO EDITOR
|Year : 2014 | Volume
| Issue : 2 | Page : 200
Osteochondroma of zygomatic bone and its excision through intraoral approach: A rare case report
Jagannath B Kamath1, Ankush Bansal1, Thangam Verghese Joshua2, M Gururaj1
1 Department of Orthopedics, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
2 Department of Surgery, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
|Date of Web Publication||1-Jul-2014|
Department of Orthopedics, Kasturba Medical College, Manipal University, Mangalore - 576 104, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kamath JB, Bansal A, Joshua TV, Gururaj M. Osteochondroma of zygomatic bone and its excision through intraoral approach: A rare case report. Muller J Med Sci Res 2014;5:200
|How to cite this URL:|
Kamath JB, Bansal A, Joshua TV, Gururaj M. Osteochondroma of zygomatic bone and its excision through intraoral approach: A rare case report. Muller J Med Sci Res [serial online] 2014 [cited 2020 May 31];5:200. Available from: http://www.mjmsr.net/text.asp?2014/5/2/200/135809
Osteochondroma is the most common of the benign tumors uncommonly seen in the facial bones.  Only two cases of osteochondroma of zygoma have been reported in English literature namely Koehl et al.  and Pool et al. 
We encountered an 18-year-old male presented with history of swelling in the left cheek of 4-months duration. The swelling was insidious in onset and gradually progressive. There was no history of similar bony swelling elsewhere in the body.
On examination, the swelling was painless, lobulated, well localized with distinct margins, bony hard in consistency, and fixed to the underlying bone. Skin over the swelling was freely mobile and there were no enlarged lymph nodes.
The plain X-Ray and computed tomography showed a bony projection in zygomatic arch. There was no soft tissue involvement or calcification, suggesting benign nature of the tumor. A decision was taken to surgically excise the tumor through intraoral approach for cosmetic reasons.
Under general anesthesia with intranasal intubation, the incision was placed approximately 3 to 5 mm superiorly to the mucogingival junction. Virtually no anatomic hazards were encountered in this approach. An osteotome was used to remove the outgrowth in total. Rim of normal bone was also included in the excision. Wound was closed using absorbable suture material. Postoperative healing was uneventful. The excised tumor was sent for histopathological analysis and the report was consistent with the findings of osteochondroma. The patient was followed-up for 2 years and there was no recurrence.
Osteochondroma represents the hamartomatous process with cartilage-capped bony protrusion. Men are twice as commonly affected as women and are usually in their 20s. Pain, swelling, and pressure symptoms are the indications of surgical intervention. Surgical excision can be achieved either through preauricular approach  or through intra oral maxillary vestibular approach. In case of surgical excision, a rim of normal bone should also be excised to prevent local reoccurrence. This case report emphasises the advantage of intra oral maxillary vestibular approach over the preauricular approach for the surgical excision of osteochondroma of facial bones as there is no visible scar and no danger to the temporal branch of facial nerve  as encountered in the preauricular approach. This is of immense importance in patients apprehensive of cosmesis.
| References|| |
|1.||Fonseca, Marciani, Turvey. Oral and Maxillofacial Surgery. 2 nd ed. Philadelphia, PA: Saunders Elsevier; 2009. p. 606(V2). |
|2.||Koehl GL, Tilson HB. Osteochondroma associated with facial asymmetry and masticatory dysfunction: Report of two cases. J Oral Surg 1977;35:934-9. |
|3.||Pool JW, Tilson HB, Thornton WE, Steed DL. Osteochondroma of zygomatic arch: Report of case. J Oral Surg 1979;37:673-5. |