Mandibular Movement Restoration in a Child with Bilateral Coronoid Hyperplasia: A Case Report
Keywords:coronoid hyperplasia, resection, intraoral approach, physiotherapy, Temporomandibular joint disorders
BACKGROUND: Coronoid process hyperplasia is an uncommon finding, characterized by an enlargement of the coronoid process, causing a mechanical obstacle by its interposing in the posterior portion of the maxilla or zygomatic arch.
CASE PRESENTATION: The article presents a case report of a bilateral coronoid process hyperplasia in a 3-year-old girl demonstrated with inability to open the mouth and restricted jaw movement. Panoramic x-ray and 3-dimensional computed tomographic reconstruction showed bilateral elongation of the coronoid processes associated with deformation of the mandibular condyle with no involvement of the articular space. A coronoid resection by intraoral approach was done, followed by an aggressive physiotherapy. A considerable improvement in mouth opening of 30 mm was achieved. We strongly suggest early surgical treatment of coronoid hyperplasia to recover morphology and function consequently to reduce skeletofacial deformities in young patients.CONCLUSIONS: The article presents a clinical and surgical case of bilateral coronoidectomy in a 3-year-old girl, with retrognathic mandible. The diagnosis of bilateral coronoid process hyperplasia was confirmed, and the surgical treatment was under general anesthesia, with nasotracheal intubation guided by a nasofiber endoscope, using an intraoral approach.
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Hicks JL, Iverson PH. Bilateral coronoid hyperplasia: an important cause of restricted mandibular motion. Northw Dent. 1993; 72(4):21-4. PMid:9487898
Gibbons AJ, Byrne AJ, Key SJ. Trismus due to bilateral mandibular coronoid hyperplasia. J R Army Med Corps. 2001; 147(3):311-3. http://dx.doi.org/10.1136/jramc-147-03-11 PMid:11766215
Tieghi R, Galie` M, Piersanti L, et al. Bilateral hyperplasia of the coronoid processes: clinical report. J Craniofac Surg. 2005;16:723-726. http://dx.doi.org/10.1097/01.SCS.0000157202.81438.EA PMid:16077327
Masahiro I, Mokoto I, Msashiko T, et al. Computed tomographic features of bilateral coronoid Process hyperplasia with special emphasis on patients without interference between the process and the zygomatic arch. Oral Surg Oral Med Oral Pathol Radiol Endod. 2005;99:93-100. http://dx.doi.org/10.1016/j.tripleo.2004.04.013 PMid:15599354
GaliÃ¨ M, Consorti G, Tieghi R, et al. Early surgical treatment in unilateral coronoid hyperplasia and facial asymmetry, J Craniofac Surg. 2010;21(1):129-33. http://dx.doi.org/10.1097/SCS.0b013e3181c46a30 PMid:20072021
Jaskolka, MS, Eppley, BL, van Aalst, JA. Mandibular coronoid hyperplasia in pediatric patients. J Craniofac Surg. 2007;18:849â€“854. http://dx.doi.org/10.1097/scs.0b013e3180a772ba PMid:17667676
Tavassol, F, Spalthoff, S, Essig, H, et al. Elongated coronoid process: CT-based quantitative analysis of the coronoid process and review of literature. Int J Oral Maxillofac Surg. 2012;41:331â€“338. http://dx.doi.org/10.1016/j.ijom.2011.10.033 PMid:22192388
Ramalho-Ferreira, G, Faverani, LP, Fabris, AL et al, Mandibular movement restoration through bilateral coronoidectomy by intraoral approach. J Craniofac Surg. 2011;22:988â€“991. http://dx.doi.org/10.1097/SCS.0b013e3182101674 PMid:21558896
McLoughlin PM, Hopper C, Bowley NB. Hyperplasia of the mandibular coronoid process: an analysis of 31 cases and a review of the literature. J Oral Maxillofac Surg. 1995;53:250-255. http://dx.doi.org/10.1016/0278-2391(95)90219-8
Smyth AG, Wake MJ. Recurrent bilateral coronoid hyperplasia: an unusual case. Br J Oral Maxillofac Surg. 1994;32:100-104. http://dx.doi.org/10.1016/0266-4356(94)90138-4
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