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Extra-oral photograph of the patient shows reduced mouth opening of 22 mm with deviation of the mandible towards the right side.
Source publication
Osteoma is a dense bony proliferation of otherwise normal membranous bone. This tumor is essentially restricted to the craniofacial skeleton and is rarely diagnosed in other bones. The mandible and the paranasal sinuses are the most common sites, while the involvement of the coronoid process has been reported in only 6 cases so far. This report dem...
Citations
... They occur more frequently in young adults and women. [8] This is the second case of this rare lesion reported in male. Ord et al. (1983) described a case of coronoid osteoma secondary to zygomatic-temporal fracture with paresthesia in that area. ...
An osteoma is a benign osteogenic tumor characterized by compact or cancellous bone proliferation with unknown etiology, but it may arise from cartilage or embryonal periosteum. Osteomas are rare, slow growing, usually asymptomatic until their size and position interferes with functioning. This is a report of a 53-year-old male patient who complained of difficulty in opening his mouth, which was diagnosed as an osteoma of mandibular coronoid producing pseudo ankylosis, a very unusual condition. Surgical excision of the tumor was performed, followed by physiotherapy and no recurrence was observed. This case report highlights the rare causes of pseudo ankylosis with significance to early diagnosis and intervention which can prevent further complications to the patient.
... O osteoma osteóide radiograficamente apresenta um nódulo de tecido osteóide cercado por osso reativo denso, o que o diferencia dos osteomas. A exclusão do osteossarcoma se faz pela ausência de crescimento rápido, doloroso, invadindo estruturas adjacentes, além das características radiográficas típicas de raios de sol (VASHISHTH et al., 2013). O osteoma central sintomático pode exigir uma excisão mais radical junto com o osso e pode requerer reconstrução do osso envolvido (GUNDEWAR et al., 2013). ...
Osteomas são tumores benignos compostos de osso maduro compacto ou esponjoso, podendo apresentar-se clinicamente na periferia, intraósseo, ou no interior dos tecidos moles. São essencialmente restritos ao esqueleto craniofacial, ocorrendo com maior frequência na mandíbula, sendo raramente diagnosticados em outros ossos. A variável osteoma central apresenta-se como uma massa óssea, de crescimento lento, assintomática, isolada e unilateral. Sua frequência é maior em homens, entre a segunda e quinta décadas de vida, sendo sua etiopatogenia amplamente discutida. Pode ser de origem reacional, traumatológica, inflamatória, ou alteração na fisiologia óssea. Comumente esta lesão está associada a pacientes portadores da Síndrome de Gardner. Objetiva-se, através de relato de caso clínico e revisão da literatura, discutir a causa, aspectos clínicos, radiográficos e histológicos desta neoplasia, assim como seu tratamento. Em nosso caso optamos pela exérese total da lesão pelo fato de que o tamanho da lesão era considerável e porque em nossa pesquisa foi o tratamento mais realizado entre os clínicos.
... Osteomas são neoplasias benignas resultantes da proliferação de tecido ósseo compacto ou esponjoso, sendo caracterizadas clinicamente por ser uma massa bem delimitada, séssil ou pediculada, associada à superfície óssea 7,11 . Clinicamente apresenta três variáveis: periosteal (periférica), central e extra-óssea 1,19 . Embora seja uma lesão assintomática, dependendo de sua localização e tamanho pode gerar danos estéticos devido à assimetria facial e danos funcionais à oclusão, deglutição e fala 5,6,13 . ...
... A lesão pode apresentar três variáveis. A forma central deriva do endósteo, a forma periférica deriva do periósteo, ao passo que a extra-óssea se desenvolve de estruturas do tecido muscular 1,19 . A forma mais predominante é a periosteal com proporção de 14:1 em relação à forma central, já a forma extra-óssea é a mais rara 2 . ...
... O osteoma osteiode radiograficamente apresenta um nódulo de tecido osteoide cercado por osso reativo denso, o que o diferencia dos osteomas. A exclusão do osteossarcoma se faz pela ausência de crescimento rápido, doloroso, invadindo estruturas adjacentes, além das características radiográficas típicas de raios de sol 19 . ...
... [8,9] The case described herein was osteoma of the coronoid process, which is a rare, benign, osteogenic tumor arising from the proliferation of cancellous or compact bone. [10] Coronoidectomy through an intraoral access is the treatment of choice when the tumor is small. When the bone mass is large, as in the case described herein, an extraoral or preauricular access is more indicated. ...
... [2,11] The present case is added to the only seven previous cases reported in the literature [ Table 1]. [3,10,[12][13][14][15][16] In a critical analysis of these cases, the authors conclude that the osteoma of the coronoid process is a benign tumor that can reach a signifi cant size, causing an increase in volume, facial asymmetry, limited mouth opening and fracture of the zygomatic complex in some cases. Panoramic X-rays and computer-aided tomography with three-dimensional reconstruction are required for the accurate determination of the location and size of the tumor as well as the best surgical access. ...
... [8,9] The case described herein was osteoma of the coronoid process, which is a rare, benign, osteogenic tumor arising from the proliferation of cancellous or compact bone. [10] Coronoidectomy through an intraoral access is the treatment of choice when the tumor is small. When the bone mass is large, as in the case described herein, an extraoral or preauricular access is more indicated. ...
... [2,11] The present case is added to the only seven previous cases reported in the literature [ Table 1]. [3,10,[12][13][14][15][16] In a critical analysis of these cases, the authors conclude that the osteoma of the coronoid process is a benign tumor that can reach a signifi cant size, causing an increase in volume, facial asymmetry, limited mouth opening and fracture of the zygomatic complex in some cases. Panoramic X-rays and computer-aided tomography with three-dimensional reconstruction are required for the accurate determination of the location and size of the tumor as well as the best surgical access. ...
Osteoma of the coronoid process is a rare, slow-growing tumor that can lead to restrictive mandibular movements. This paper describes a case of osteoma of the right coronoid process in a 45-year-old woman who reported progressive facial asymmetry and the loss of mandibular movements. Aspects regarding the differential diagnosis, treatment, surgical access, possible complications and postoperative follow up of the case are also discussed. The osteoma of the coronoid process is a benign tumor that can reach a significant size, causing an increase in volume, facial asymmetry, limited mouth opening and fracture of the zygomatic complex in some cases. The combination of extraoral and intraoral accesses is useful in the case of large tumors of difficult access, such as in this case reported.
Purpose:
Extra-articular temporomandibular bony ankylosis between the zygomatic bone and coronoid process is a rare condition. Currently, there are fewer than 40 cases reported in the English-language literature. The aim of this study was to report a case of zygomatico-coronoid ankylosis with surgical intervention and a literature review.
Materials and methods:
Through a PubMed search from 1946 to February 2018, using the terms ("extra-capsular" OR "zygomatico-coronoid" OR "extra-articular") AND ("ankylosis"), 61 articles were initially identified. After screening, manual reviewing, and including additional articles through reviews of the reference lists, 26 reports (33 patients) were included in the analysis.
Results:
Patients' age ranged from 12 to 71 years (mean, 36.62 yr; standard deviation, 16.24 yr). The gender composition of patients was male (n = 20; 60.6%), female (n = 12; 36.4%), and unknown (n = 1; 0.3%), with a clear male predominance. The etiologies were trauma (n = 25; 75.8%), infection (n = 3; 9.1%), surgical complication (n = 4; 12.1%), and radiotherapy for maxillary cancer (squamous cell carcinoma; n = 1; 3.0%). The treatment options were surgical intervention through an intraoral approach (n = 19; 57.6%), an extraoral approach (n = 10; 30.3%), and intraoral and extraoral approaches (n = 2; 6.1%) and nonsurgical intervention (n = 2; 6.1%).
Conclusion:
Zygomatico-coronoid ankylosis is a possible cause of mouth-opening limitation, particularly in relation to facial trauma. However, it can be easily overlooked because of the rarity of zygomatico-coronoid ankylosis and the attention focused on the joint. Surgical intervention is regarded as a good treatment to improve mouth-opening limitation.
