Treatment of bilateral coronoid hyperplasia by intraoral coronoidotomy: report of two cases

Abstract

Objective: This study aims to report two cases of coronoidotomy performed through an intraoral approach with the interposition of the buccal fat pad for the treatment of bilateral coronoid process hyperplasia. Case report: In the first case, a 16-year-old male patient complained of difficulty in mouth opening, which led to dietary and psychosocial issues. Clinical examination showed a limited mouth opening of 21.8 mm, without other abnormalities. In the second case, a 21-year-old male patient was referred to the CTBMF/UFRN service for evaluation and management of bilateral coronoid hyperplasia, reporting mouth opening difficulty since the age of 15, limited to 21 mm. Both patients underwent surgical treatment in a hospital setting under general anesthesia, through intraoral coronoidotomy with buccal fat pad interposition, achieving immediate improvement in mouth opening during surgery. Post-operatively, both patients were followed with physical therapy and showed stable occlusion and a significant increase in mouth opening, with follow-ups at 5 years and 2 years and 4 months, respectively. Conclusion: In these cases, coronoidotomy proved to be a simple, minimally invasive technique with satisfactory outcomes. Emphasis is placed on the importance of a detailed anamnesis, multidisciplinary approach, and long-term follow-up to ensure treatment success.