Effectiveness of treatment by coronoidectomy and active rehabilitation in Langenbeck or Jacob diseases. A retrospective study of 20 cases

Abstract

BackgroundThe objective of this study was to evaluate the mouth opening (MO) in patients with Langenbeck or Jacob diseases after a multimodal treatment combining the coronoidectomy and a self or assisted postoperative rehabilitation. MethodsThis observational retrospective study included patients who had clinically impacted MO limitation. All patients underwent unilateral or bilateral coronoidectomy and then physical therapy for at least 3 months. MO measurements were compared between the preoperative time (M0), the immediate postoperative time (M1) and the last follow-up (M2). Other data regarding the surgical procedure and the postoperative rehabilitation were collected. ResultsTwenty patients were included. The MO was significantly improved from 19.15 ± 7.02 mm at M0 to 38.00 ± 7.62 mm at M1 (p = 0.0002). After a mean follow-up of 21.5 ± 40.5 months, the mean MO was 32.85 ± 5.69 mm (M2). All patients underwent coronoidectomy through an intraoral approach except for one patient who was given a combined extra-oral approach for a recurrent disease. Rehabilitation protocol included assisted physiotherapy and self-rehabilitation in 7 patients as well as just self-rehabilitation in 13 patients. No patient showed worsening or stagnation of MO. ConclusionsThe multimodal treatment combining the surgical removal of the coronoid process and an active rehabilitation performed by the patient himself or assisted by a physiotherapist seems effective in Langenbeck or Jacob diseases.