Limitation of mouth opening caused by osteochondroma of the coronoid process

• Published in: Oral surgery, oral medicine, oral pathology, oral radiology and endodontics Vol. 112; no. 6; pp. e64 - e68
• Main Authors: Acosta-Feria, Manuel, MD, Villar-Puchades, Raquel, MD, Haro-Luna, Juan José, MD, Ramos-Medina, Benito, MD, García-Solano, Eulalia, MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.12.2011
• Subjects: Asymmetry; Bone Cysts - etiology; Bone tumors; Cartilage; Computed tomography; Cysts; Dentistry; Facial Asymmetry - etiology; Facial nerve; Female; Humans; Imaging, Three-Dimensional - methods; Injuries; integrated circuits; Literature reviews; Mandibular Neoplasms - complications; Middle Aged; Mouth; osteochondroma; Osteochondroma - complications; Radiography, Panoramic; Reconstruction; Reconstructive Surgical Procedures - methods; Surgery; Tomography, X-Ray Computed - methods; Trismus - etiology; zygoma; Zygoma - pathology
• ISSN: 1079-2104; 1528-395X
• DOI: 10.1016/j.tripleo.2011.05.020

Background 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. Study design 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. Results 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. Conclusions 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.