A 51-year-old woman was referred for evaluation of headache, right-side jaw pain, paresthesia, and trismus. The patient reported that the facial and jaw symptoms had evolved gradually over the past 5 years and that multiple medical therapies had provided only minimal relief of pain. The patient’s medical history included anxiety, depression, emphysema, hyperlipidemia, migraines, and pseudoseizures. She denied prior head trauma and had no pertinent surgical history. On physical examination, the patient had normal body habitus and reported bilateral tenderness of the temporomandibular joints and paresthesia of the right trigeminal nerve in the V2 and V3 distribution with intact masseteric nerve and symmetric facial nerve. Audiometric evaluation showed normal hearing bilaterally. Magnetic resonance imaging (MRI) revealed a cystic mass in the right side of infratemporal fossa (ITF) that was nonenhancing on T1 sequencing with contrast and hyperintense on T2 (Figure 1A).
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: James G. Naples, MD, Division of Otolaryngology–Head & Neck Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215 (firstname.lastname@example.org).
Published Online: March 31, 2022. doi:10.1001/jamaoto.2022.0175
Conflict of Interest Disclosures: Dr Naples reported receiving honorarium from DeckerMed for serving as editor-in-chief, outside the submitted work. No other disclosures were reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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