BILATERAL CORONOID HYPERPLASIA CAUSING SEVERE MOUTH RESTRICTION: CASE REPORT & LITERATURE REVIEW
Authors:
Moschonas G, Papakosta V, Pyraki M, Lefantzis N, Vasiliou S
Affiliation:
Department of Oral and Maxillofacial Surgery, University JosAttikon Hospital, School of Medicine, National and Kapodistrian University of Athens
Doi: 10.54936/haoms242p21
ABSTRACT:
Objectives: Coronoid process hyperplasia is a rare condition that can lead to limited mouth opening by impingement of the elongated coronoid process on the medial surface of the zygoma. The aetiology is not completely known. This poster reports a case of trismus due to bilateral coronoid hyperplasia, diagnosed late and treated successfully with coronoidectomy and postoperative physiotherapy. A review of the literature is also presented, concerning epidemiology, etiology, diagnosis and treatment.
Materials and methods: A 17 year old male presented at the Department of Oral and Maxillofacial Surgery complaining of limited mouth opening, progressively worsening for the last two years. The preoperative mouth opening was measured at 15mm. Radiographic and CT imaging revealed significant enlargement of both coronoid processes. His medical history was uneventful. Intraoral bilateral coronoidectomy was carried out, postoperative physiotherapy by a Physiotherapist and regular longlasting follow up were advised.
Results: A mouth opening of 25mm was achieved just after the operation. Postoperative course was uneventful. After 3 months of physiotherapy, the patient achieved a mouth opening of 38mm. The biopsy showed no specific findings and the hyperplasia was accredited to temporalis muscle hyperactivity.
Conclusions: Treatment of coronoid hyperplasia aims to restore limited mouth opening whilst maintaining a long term stable result. Early diagnosis is crucial, but it is often delayed due to the symptoms being attributed to TMJ disorders. Progressive limitation of mouth opening without other symptoms related to temporomandibular or masticatory muscle disorder, are clinical signs indicative of this condition. CT is the imaging modality of choice, since Panoramic X-rays can often be non diagnostic. Surgical treatment is necessary in the majority of cases with intraoral coronoidectomy being the operative procedure most commonly performed. Postoperative rehabilitation is of paramount importance, since tissue scarring can compromise the surgical result.
KEY WORDS:
Authors:
Moschonas G, Papakosta V, Pyraki M, Lefantzis N, Vasiliou S
Affiliation:
Department of Oral and Maxillofacial Surgery, University JosAttikon Hospital, School of Medicine, National and Kapodistrian University of Athens
Doi: 10.54936/haoms242p21
ABSTRACT:
Objectives: Coronoid process hyperplasia is a rare condition that can lead to limited mouth opening by impingement of the elongated coronoid process on the medial surface of the zygoma. The aetiology is not completely known. This poster reports a case of trismus due to bilateral coronoid hyperplasia, diagnosed late and treated successfully with coronoidectomy and postoperative physiotherapy. A review of the literature is also presented, concerning epidemiology, etiology, diagnosis and treatment.
Materials and methods: A 17 year old male presented at the Department of Oral and Maxillofacial Surgery complaining of limited mouth opening, progressively worsening for the last two years. The preoperative mouth opening was measured at 15mm. Radiographic and CT imaging revealed significant enlargement of both coronoid processes. His medical history was uneventful. Intraoral bilateral coronoidectomy was carried out, postoperative physiotherapy by a Physiotherapist and regular longlasting follow up were advised.
Results: A mouth opening of 25mm was achieved just after the operation. Postoperative course was uneventful. After 3 months of physiotherapy, the patient achieved a mouth opening of 38mm. The biopsy showed no specific findings and the hyperplasia was accredited to temporalis muscle hyperactivity.
Conclusions: Treatment of coronoid hyperplasia aims to restore limited mouth opening whilst maintaining a long term stable result. Early diagnosis is crucial, but it is often delayed due to the symptoms being attributed to TMJ disorders. Progressive limitation of mouth opening without other symptoms related to temporomandibular or masticatory muscle disorder, are clinical signs indicative of this condition. CT is the imaging modality of choice, since Panoramic X-rays can often be non diagnostic. Surgical treatment is necessary in the majority of cases with intraoral coronoidectomy being the operative procedure most commonly performed. Postoperative rehabilitation is of paramount importance, since tissue scarring can compromise the surgical result.
KEY WORDS: