Difficulty of Arch Reduction with Gillies Temporal Approach in a Coronoid Hyperplasia Case.

Abstract

Bilateral coronoid hyperplasia is an abnormal elongation of the mandibular coronoid process which is rare in occurrence and causes progressive but slow reduction in mouth opening. In case of reduction in zygomatic arch fracture by Gillies temporal approach, the presence of bilateral coronoid hyperplasia can be a possible factor for hindrance and improper reduction. We propose a technical note to overcome this hindrance caused by the coronoid hyperplasia and propose tips and tricks to successful reduction in zygomatic arch. Adequate reduction in the zygomatic arch and pretrauma mouth opening was achieved. Manual repositioning of the mandible during Gillies temporal approach along with ultrasound guidance leads to a satisfactory outcome.