双侧冠突过长导致开口受限2例

doi:10.7518/hxkq.2022.04.016

华西口腔医学杂志 ›› 2022, Vol. 40 ›› Issue (4): 476-482.doi: 10.7518/hxkq.2022.04.016

双侧冠突过长导致开口受限2例

张艳艳¹(), 刘飞¹, 沈颉飞¹, 李晓箐²()

^1.口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院口腔修复科，成都 610041
^2.口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院颞下颌关节科，成都 610041

收稿日期:2021-09-12 修回日期:2022-04-30 出版日期:2022-07-25 发布日期:2022-07-27
通讯作者: 李晓箐 E-mail:hxkqyanyanzhang@163.com;xuanxqli@163.com
作者简介:张艳艳，博士，E-mail：hxkqyanyanzhang@163.com
基金资助:
四川省科技厅应用基础研究项目(2020YJ0224);中国博士后科学基金面上项目(2020M683329)

Two cases of bilateral coronoid process hyperplasia causing restricted mouth opening

Zhang Yanyan¹(), Liu Fei¹, Shen Jiefei¹, Li Xiaoqing²()

^1.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
^2.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2021-09-12 Revised:2022-04-30 Online:2022-07-25 Published:2022-07-27
Contact: Li Xiaoqing E-mail:hxkqyanyanzhang@163.com;xuanxqli@163.com
Supported by:
the Grants of the Department of Science and Technology of Sichuan Province(2020YJ0224);China Postdoctoral Science Foundation(2020M683329);Correspondence: Li Xiaoqing, E-mail: xuanxqli@163.com

摘要/Abstract

摘要：

冠突过长（CPH）是一种罕见的下颌骨发育过程中冠突形态和长度的异常疾病，本文报道2例双侧CPH引起下颌运动及开口受限的病例资料，通过报道病例的临床表现、X线检查、治疗及预后，为该疾病的诊疗提供参考。这2例CPH病例经外科切除伸长的冠突后，即刻开口度均增加到近三指，其中1例治疗6个月后，随访开口度正常，而另外1例术后2年CPH复发。CPH的病因暂不明确，可能与多种因素相关。CPH导致开口受限的情况在临床上极其少见，易与其他疾病混淆导致误诊。因此，应综合运用临床及影像学加以鉴别诊断。外科手术切除伸长的冠突是目前公认的治疗方式，而术后长期有效的开口训练对治疗效果的维持至关重要。

关键词: 冠突过长, 开口受限, 病因, 诊断, 治疗

Abstract:

Coronoid process hyperplasia (CPH) is a rare condition characterized by the increase in the size of the coronoid process, mainly occurring in the second decades of human life. To provide a reference for the diagnosis and treatment of this disease, we reported the clinical manifestations of two cases, X-ray examination, treatment, and prognosis with mandibular movement and restricted mouth opening (RMO) caused by bilateral CPH. The opening degree of the two cases described in the article increased to almost 40 mm immediately after the elongated coronoid process was surgically removed and a case was maintained normal after 2 months. In another case, CPH recurred after 2 years of follow-up. The etiology of CPH is still unclear, which is associated with various factors. RMO caused by CPH is extremely rare in clinical practice, and it is easy for patients to get confused and be misdiagnosed. It should be diagnosed using comprehensive methods of clinical studies and imaging modalities. Currently, surgical coronoidectomy is an accepted treatment of CPH. Long-term effective opening training is crucial in maintaining its therapeutic effect.

Key words: coracoid process hyperplasia, restricted mouth opening, etiology, diagnosis, treatment

中图分类号:

R 782.6

张艳艳, 刘飞, 沈颉飞, 李晓箐. 双侧冠突过长导致开口受限2例[J]. 华西口腔医学杂志, 2022, 40(4): 476-482.

Zhang Yanyan, Liu Fei, Shen Jiefei, Li Xiaoqing. Two cases of bilateral coronoid process hyperplasia causing restricted mouth opening[J]. West China Journal of Stomatology, 2022, 40(4): 476-482.

图/表 8

图 1

图 2

图 3

图 4

图 5

图 6

图 7

图 8

参考文献 38

1	Tolentino MCA, Assis JS, Cardoso CAA, et al. Mandibular coronoid process hyperplasia: a case report[J]. Revista CEFAC, 2018, 20(3): 400-405.
2	Costa YM, Porporatti AL, Stuginski-Barbosa J, et al. Coronoid process hyperplasia: an unusual cause of mandibular hypomobility[J]. Braz Dent J, 2012, 23(3): 252-255.
3	d’Apuzzo F, Minervini G, Grassia V, et al. Mandibular coronoid process hypertrophy: diagnosis and 20-year follow-up with CBCT, MRI and EMG evaluations[J]. Appl Sci, 2021, 11(10): 4504.
4	Starch-Jensen T, Kjellerup AD. Bilateral elongated mandibular coronoid process and restricted mouth opening: a case report[J]. Open Dent J, 2017, 11: 670-678.
5	de Leeuw R. Orofacial pain[M]. 4th ed. Chicago: Quintessence, 2008.
6	Mulder CH, Kalaykova SI, Gortzak RA. Coronoid process hyperplasia: a systematic review of the literature from 1995[J]. Int J Oral Maxillofac Surg, 2012, 41(12): 1483-1489.
7	Farronato M, Lucchina AG, Mortellaro C, et al. Bilateral hyperplasia of the coronoid process in pediatric patients: what is the gold standard for treatment[J]. J Craniofac Surg, 2019, 30(4): 1058-1063.
8	Goh YC, Tan CC, Lim D. Coronoid hyperplasia: a review[J]. J Stomatol Oral Maxillofac Surg, 2020, 121(4): 397-403.
9	Mano T, Ueyama Y, Koyama T, et al. Trismus due to bilateral coronoid hyperplasia in a child: case report[J]. J Oral Maxillofac Surg, 2005, 63(3): 399-401.
10	Coll-Anglada M, Acero-Sanz J, Vila-Masana I, et al. Jacob’s disease secondary to coronoid process osteochondroma. A case report[J]. Med Oral Patol Oral Cir Bucal, 2011, 16(6): e708-e710.
11	Chen CM, Chen CM, Ho CM, et al. Gap coronoidotomy for management of coronoid process hyperplasia of the mandible[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2011, 112(6): e1-e4.
12	Ribeiro da Silva J, Pereira RDS, Águeda C, et al. Bilate-ral coronoid hyperplasia in a 43-year-old patient treated with intraoral coronoidectomy[J]. J Craniofac Surg, 2017, 28(4): e402-e403.
13	Kim WG, Lee CA, Kim WJ. Severe trismus due to bilateral elongated mandibular coronoid process in an infantile-onset Pompe disease patient: a case report[J]. Int J Pediatr Otorhinolaryngol Extra, 2017, 17: 6-10.
14	Chang CC, Allori AC, Wang E, et al. A quantitative three-dimensional analysis of coronoid hypertrophy in pediatric craniofacial malformations[J]. Plast Reconstr Surg, 2012, 129(2): 312e-318e.
15	Ghazizadeh M, Sheikhi M, Salehi MM, et al. Bilateral coronoid hyperplasia causing painless limitation of mandibular movement[J]. Radiol Case Rep, 2017, 13(1): 112-117.
16	Farrar WB, McCarty WL Jr. Inferior joint space arthrography and characteristics of condylar paths in internal derangements of the TMJ[J]. J Prosthet Dent, 1979, 41(5): 548-555.
17	Puche M, Guijarro-Martínez R, Pérez-Herrezuelo G, et al. The hypothetical role of congenital hypotonia in the development of early coronoid hyperplasia[J]. J Craniomaxillofac Surg, 2012, 40(6): e155-e158.
18	Bayar GR, Akcam T, Gulses A, et al. An excessive coronoid hyperplasia with suspected traumatic etiology resulting in mandibular hypomobility[J]. Cranio, 2012, 30(2): 144-149.
19	Smyth AG, Wake MJ. Recurrent bilateral coronoid hyperplasia: an unusual case[J]. Br J Oral Maxillofac Surg, 1994, 32(2): 100-104.
20	Anthwal N, Peters H, Tucker AS. Species-specific modifications of mandible shape reveal independent mechanisms for growth and initiation of the coronoid[J]. Evo-devo, 2015, 6: 35.
21	van Hoof RF, Besling WF. Coronoid process enlargement[J]. Br J Oral Surg, 1973, 10(3): 339-348.
22	Leonardi R, Caltabiano M, Lo Muzio L, et al. Bilateral hyperplasia of the mandibular coronoid processes in patients with nevoid basal cell carcinoma syndrome: an undescribed sign[J]. Am J Med Genet, 2002, 110(4): 400-403.
23	Colquhoun A, Cathro I, Kumara R, et al. Bilateral coronoid hyperplasia in two brothers[J]. Dentomaxillofac Radiol, 2002, 31(2): 142-146.
24	Khandavilli SD, Pattni N, Naredla PR, et al. First case of bilateral coronoid hyperplasia in monozygotic twin sisters-a new aetiological perspective[J]. Oral Maxillofac Surg, 2016, 20(4): 441-443.
25	Wenghoefer M, Merkx M, Steiner M, et al. Hyperplasia of the coronoid process[J]. Asian J Oral Maxillofac Surg, 2006, 18(1): 51-58.
26	Kim SM, Lee JH, Kim HJ, et al. Mouth opening limitation caused by coronoid hyperplasia: a report of four cases[J]. J Korean Assoc Oral Maxillofac Surg, 2014, 40(6): 301-307.
27	Fernández Ferro M, Fernández Sanromán J, Sandoval Gutierrez J, et al. Treatment of bilateral hyperplasia of the coronoid process of the mandible. Presentation of a case and review of the literature[J]. Med Oral Patol Oral Cir Bucal, 2008, 13(9): E595-E598.
28	Wada T, Ram S. Limited mouth opening secondary to diffuse systemic sclerosis[J]. Case Rep Dent, 2013, 2013: 937487.
29	许卫华, 马绪臣, 赵燕萍, 等. 喙突过长致开口受限的临床观察[J]. 现代口腔医学杂志, 2004, 18(5): 432-435.
	Xu WH, Ma XC, Zhao YP, et al. Coronoid process hyperplasia related mouth opening limitation[J]. J Modern Stomatol, 2004, 18(5): 432-435.
30	Nayak S, Patra S, Singh G, et al. Study of the size of the coronoid process of mandible[J]. J Anat Soc India, 2016, 65(S2): S2-S3.
31	Tavassol F, Spalthoff S, Essig H, et al. Elongated coronoid process: CT-based quantitative analysis of the coronoid process and review of literature[J]. Int J Oral Maxillofac Surg, 2012, 41(3): 331-338.
32	Stopa Z, Wanyura H, Kowalczyk P. Coronoid-condylar index in assessing of mandibular coronoid hyperplasia. Preliminary results[J]. Adv Med Sci, 2013, 58(2): 429-433.
33	Galiè M, Consorti G, Tieghi R, et al. Early surgical treatment in unilateral coronoid hyperplasia and facial asymmetry[J]. J Craniofac Surg, 2010, 21(1): 129-133.
34	Zhong SC, Xu ZJ, Zhang ZG, et al. Bilateral coronoid hyperplasia (Jacob disease on right and elongation on left): report of a case and literature review[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 107(3): e64-e67.
35	Ramalho-Ferreira G, Faverani LP, Fabris AL, et al. Mandibular movement restoration through bilateral coronoidectomy by intraoral approach[J]. J Craniofac Surg, 2011, 22(3): 988-991.
36	Robiony M, Casadei M, Costa F. Minimally invasive surgery for coronoid hyperplasia: endoscopically assisted intraoral coronoidectomy[J]. J Craniofac Surg, 2012, 23(6): 1838-1840.
37	张媛媛, 李娜. 双侧喙突过长1例[J]. 疑难病杂志, 2014, 13(8): 799.
	Zhang YY, Li N. Case of coronoid process hyperplasia[J]. J Diffic Compl Cas, 2014, 13(8): 799.
38	Gerbino G, Bianchi SD, Bernardi M, et al. Hyperplasia of the mandibular coronoid process: long-term follow-up after coronoidotomy[J]. J Craniomaxillofac Surg, 1997, 25(3): 169-173.

[1]	刘晓琳, 任群, 白九平, 康培, 任贵云, 李向军, 冯晓伟. 基于锥形束CT的1 138颗多生牙影像学特征分析[J]. 华西口腔医学杂志, 2023, 41(6): 671-677.
[2]	张晓玲, 薛宁宁, 阮敏慧, 曾昕. 口腔黏膜溃疡损害出现短暂自愈的朗格汉斯细胞组织细胞增生症1例[J]. 华西口腔医学杂志, 2023, 41(5): 592-598.
[3]	王铁彪, 周五超, 肖寅, 程家龙, 欧阳洲城, 程晨, 习伟宏. 改良关节盘锚固术在颞下颌关节盘穿孔、破裂治疗中的应用[J]. 华西口腔医学杂志, 2023, 41(4): 434-442.
[4]	蔡美娟, 向绍雯, 谢成婕, 欧阳楚红, 童方丽. 意向性牙再植治疗下颌第二磨牙根管治疗失败病例1例[J]. 华西口腔医学杂志, 2023, 41(4): 471-477.
[5]	郑艳, 闫柳清, 华成舸, 梁新华, 杨征. 四川省口腔医疗机构和口腔综合治疗台配置现状分析[J]. 华西口腔医学杂志, 2023, 41(3): 333-340.
[6]	李成蹊, 宋卫健. 上颌侧切牙Ⅱ型和ⅢA型双牙内陷根管治疗1例[J]. 华西口腔医学杂志, 2023, 41(2): 232-236.
[7]	蒋鸿杰, 李茂, 唐月阳, 汤亚玲. 淋巴上皮囊肿恶变1例[J]. 华西口腔医学杂志, 2023, 41(2): 237-242.
[8]	冯志强, 安金刚, 张益, 贺洋. 晚期药物相关性颌骨坏死的手术治疗[J]. 华西口腔医学杂志, 2023, 41(1): 43-51.
[9]	刘磊, 向中正, 李一, 郭伟, 杨凯, 王军, 孙志军, 任国欣, 张建国, 孙沫逸, 冉伟, 黄桂林, 唐瞻贵, 李龙江. 头颈部鳞癌免疫检查点抑制剂治疗专家共识[J]. 华西口腔医学杂志, 2022, 40(6): 619-628.
[10]	李煌, 武秀萍, 黄兰, 徐晓梅, 康娜, 韩向龙, 李宇, 赵宁, 江凌勇, 谢贤聚, 郭杰, 李志华, 莫水学, 刘楚峰, 胡江天, 施洁珺, 曹猛, 胡炜, 曹阳, 宋锦璘, 汤旭娜, 白丁. 正畸根尖区牙根外吸收的风险因素及其临床处理建议的专家共识[J]. 华西口腔医学杂志, 2022, 40(6): 629-637.
[11]	杨雯君, 韩佳佳, 王逸尘, 李凤翔, 杜启涛. 不同方法去除根管内充填材料的效果评价[J]. 华西口腔医学杂志, 2022, 40(6): 685-689.
[12]	郑琛, 苏吉梅, 梁鑫, 吴娟, 顾伟忠, 赵雄. 先天性颗粒细胞龈瘤的临床病理分析[J]. 华西口腔医学杂志, 2022, 40(6): 710-715.
[13]	王显文, 陈谦明, 江潞. 1例表现为非典型性血管增生的放射性口腔黏膜炎[J]. 华西口腔医学杂志, 2022, 40(6): 721-726.
[14]	张琼, 汪俊, 夏斌, 赵玮, 陈旭, 蒋备战, 黄洋, 吴礼安, 袁国华, 邹静. 低龄儿童龋的临床管理专家共识[J]. 华西口腔医学杂志, 2022, 40(5): 495-503.
[15]	刘建山, 刘磐, 彭利伟, 王志兴. 副腮腺低级别导管内癌1例[J]. 华西口腔医学杂志, 2022, 40(5): 606-609.

双侧冠突过长导致开口受限2例

Two cases of bilateral coronoid process hyperplasia causing restricted mouth opening

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 8

参考文献 38

相关文章 15

编辑推荐

Metrics

本文评价