A Case of Recurrent Bilateral Coronoid Process Hyperplasia of the Mandible Requiring a Repeat Coronoidectomy

Abstract

Coronoid process hyperplasia clinically appears as a progressive reduction in mandibular opening resulting from contact of the enlarged coronoid process with the medial surface of the zygomatic arch.
A case of bilateral coronoid process hyperplasia of the mandible is described. The patient was a 13-year-old male who presented with a chief complaint of limited mandibular movement.
A bilateral coronoidectomy was performed by the intraoral approach under general anesthesia. Immediately thereafter, the patient was able to achieve an interincisal opening of 45mm, however, at 5 years postoperatively he complained of mouth opening pain. Computed tomography showed that both coronoid processes had extended above the zygomatic arch, indicating a bilateral reenlargement of the coronoid processes. A bilateral coronoidectomy was performed by the intraoral approach under general anesthesia again when the patient was 19 years old. Following jaw stretching exercise training, the patient still has an interincisal opening of 50mm at one year postoperatively.
The best treatment for coronoid process hyperplasia is a coronoidectomy with a section through the bases of both coronoids. However, we should exercise caution when recommending a coronoidectomy in young persons.