Abstract
The formation of a new joint between a pathologically enlarged coronoid process and the body of the malar bone is known as Jacob's disease. Hyperplasia of the coronoid process was first described in 1853 by von Langenbeck, and it was not until 1899 when Oscar Jacob described the disease that was named after him. Jacob's disease is an uncommon entity with only a few cases documented in the literature. The condition manifests at first with progressive limitation of the oral opening and facial asymmetry. The pain is infrequent and mainly affects young patients. Temporal muscle hyperactivity, cranial trauma, chronic displacement of the ipsilateral temporomandibular joint, endocrine stimuli and genetic alterations have been postulated as possible factors. The definitive diagnosis is by histopathology and it is necessary that bone hyperplasia is confirmed, as well as the presence of cartilage and synovial capsule forming the new joint between the malar bone and the coronoid process. We present a 10-year-old patient with a history of childhood trauma in the left preauricular region. It presented to our service with a history of progressive limitation of the oral opening. Computed tomography (CT) revealed an elongation of the bilateral coronoid process, in contact with homolateral zygomatic bone, causing its deformation. Surgery under general anesthesia was performed through the intraoral vestibular route. Histopathology confirmed the diagnosis of Jacob's disease. We review the literature regarding the etiology, pathogenesis, clinical characteristics, diagnosis and treatment of this condition.
Highlights
Coronoid hyperplasia is a very uncommon pathological condition, characterized by a disproportionate and progressive growth, both in volume and in height, of the unilateral or bilateral mandibular coronoids.[1]
The neoplasms are characterized as unilateral while those of development are bilateral, which is why neoplastic or unilateral Jacob's disease whose symptoms are similar and in which, in addition to coronoid hyperplasia, synovial joint formation occurs between the coronoid process and ipsilateral zygomatic bone, should be excluded as coronoid process hyperplasia
It was first described by Jacob in 1895. Both entities present as a progressive and asymptomatic limitation of the oral opening, without abnormalities in occlusion. This limitation of the mandibular movements is secondary to a mechanical blockage of the coronoid processes that occurs behind the body of the malar bone, causing a temporomandibular pseudo-ankylosis
Summary
Coronoid hyperplasia is a very uncommon pathological condition, characterized by a disproportionate and progressive growth, both in volume and in height, of the unilateral or bilateral mandibular coronoids.[1]. (CPH) since they present a different microstructure.[3, 4] Jacob's5 disease is a rare condition that consists of the formation of a pseudoarticulation between the enlarged coronoid process and the internal face of the zygomatic bone. Both entities present as a progressive and asymptomatic limitation of the oral opening, without abnormalities in occlusion This limitation of the mandibular movements is secondary to a mechanical blockage of the coronoid processes that occurs behind the body of the malar bone, causing a temporomandibular pseudo-ankylosis. An elongated left coronoid process was identified in a panoramic radiograph, so a computed tomography with three-dimensional reconstruction (3D CT scan) was requested, which confirmed the bilateral coronoid hyperplasia This process produced a mechanical block on the inside of the body of the homolateral malar bone, with signs of bone remodeling, contacting both structures during the oral opening. The patient was referred to the maxillary orthopedics service to follow up and implement the corresponding device
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