Coronoid impingement syndrome: literature review and clinical management

Priti Acharya,Andrew Stewart,Farhad B Naini

doi:10.1186/s40902-017-0111-7

Abstract

BackgroundThis case report discusses the unusual presentation of limited mouth opening as a result of bilateral coronoid process hyperplasia.Case presentationA 14.5-year-old male patient of white Caucasian ethnicity presented with limited mouth opening, mandibular asymmetry, and dental crowding. Investigations confirmed bilateral coronoid process hyperplasia and management involved bilateral intraoral coronoidectomy surgery under general anaesthesia, followed by muscular rehabilitation. Mouth opening was restored to average maximum opening within 4 months of surgery.ConclusionLimited mouth opening is a common presentation to medical and dental professionals. The rare but feasible diagnosis of coronoid impingement syndrome should not be overlooked.

Highlights

BackgroundCoronoid process hyperplasia is defined as ‘an abnormal elongation of the coronoid process, formed of histologically normal bone’ [1]
This case report discusses the unusual presentation of limited mouth opening as a result of bilateral coronoid process hyperplasia
Case presentation A 14.5-year-old male patient of white Caucasian ethnicity (EP) presented to the Oral and Maxillofacial Surgery team, complaining of limited mouth opening and dental crowding. He reported functional and social difficulties associated with his limited mouth opening, and he was unable to have orthodontic treatment due to the same reason

Summary

Background

Coronoid process hyperplasia is defined as ‘an abnormal elongation of the coronoid process, formed of histologically normal bone’ [1]. Case presentation A 14.5-year-old male patient of white Caucasian ethnicity (EP) presented to the Oral and Maxillofacial Surgery team, complaining of limited mouth opening and dental crowding He reported functional and social difficulties associated with his limited mouth opening, and he was unable to have orthodontic treatment due to the same reason. CT scans taken in a closed and open mouth position confirmed the presence of bilateral elongated coronoid processes with apparent impingement between the coronoid processes and zygomatic arches and the presence of bilateral pseudoarthrosis between the prominent coronoid process and the internal surface of the zygoma, as viewed in the parasagittal plane (Fig. 8a, b) Both temporomandibular joint complexes were morphologically normal with slightly underdeveloped condylar processes and a noted absence of expected movement of the condyles or discs in the open mouth position.

Discussion

Conclusions