Limitation of mouth opening caused by osteochondroma of the coronoid process

Abstract

Osteochondroma at the level of the coronoid process is unusual, causing a slowly progressive facial asymmetry and limitation of mouth opening. Histologically, it is a bone tumor covered by a thin capsule of cartilage. We present a literature review of cases published to date and present a new case in which osteochondroma originating in the coronoid process was associated with the formation of a cyst at the body of the zygoma, necessitating the reconstruction of the body of the zygoma. A 55-year-old woman had a bone tumor in the right malar region, producing a limitation in mouth opening. After preoperative computerized tomography, we decided to excise the lesion and pseudocyst with the use of a combined subciliary and coronal approach, reconstructing the body of the zygoma with a cortical chip of calvarian bone. The patient regained normal mouth opening, without injury to the fronto-orbital branches of the facial nerve and no recurrence of the tumor to date. Osteochondroma is a slow-growing tumor that causes progressive facial asymmetry and limitation of mouth opening. The treatment of choice for symptomatic osteochondromas is surgical resection.