Mavili E, Akyürek M, Kayikçioğlu A
Department of Plastic and Reconstructive Surgery, Hacettepe University, Medical School, Ankara, Turkey.
Ann Plast Surg. 1999 Feb;42(2):211-6.
Coronoid process hyperplasia (CPH) is an uncommon disorder characterized by an enlarged coronoid process impinging against the posterior aspect of the zygomatic arch. Young male adults are usually affected, presenting with limited mouth opening, which is typically painless and progressive in nature. The diagnosis of true CPH is established by the findings of (1) uniform coronoid enlargement on radiographic examination and (2) normal bone structure on histopathological examination (i.e., the specimen should be free of any neoplastic growth, such as the previously reported cases of coronoid osteomas, osteochondromas, or exostoses). The treatment is mainly surgical, by means of a coronoidectomy. An intraoral approach is mostly preferred for this procedure to avoid an external scar. However, to avoid the drawbacks of this approach, such as limited exposure and the risk of hematoma and subsequent fibrosis, an extraoral approach may be indicated. This report describes a case of true unilateral CPH in a 17-year-old boy who presented with progressive limited mouth opening in the absence of any pain. Computed tomography (CT) demonstrated a uniformly enlarged right coronoid process. A coronoidectomy was performed with the aid of endoscopic systems, approaching via two short incisions in the temporal scalp. Histopathological examination of the specimen demonstrated essentially a normal bony structure with no evidence of a neoplasm. The authors present the endoscopically assisted technique of coronoid process excision as an alternative method of surgical treatment of CPH and any mass of the coronoid process in general. With this method, the incision is much shorter than a conventional coronal incision and thus morbidity is diminished considerably.
冠状突增生（CPH）是一种罕见的疾病，其特征为冠状突增大并撞击颧弓后部。年轻男性成年人通常会受到影响，表现为张口受限，这种情况通常无痛且呈进行性发展。真性CPH的诊断依据以下发现确立：（1）影像学检查显示冠状突均匀增大；（2）组织病理学检查显示骨结构正常（即标本应无任何肿瘤性生长，如先前报道的冠状突骨瘤、骨软骨瘤或外生骨疣病例）。治疗主要是手术治疗，即通过冠状突切除术。该手术大多首选经口入路以避免外部瘢痕。然而，为避免这种入路的缺点，如暴露受限以及血肿和随后纤维化的风险，可能需要采用口外入路。本报告描述了一例17岁男孩的真性单侧CPH病例，该男孩表现为进行性张口受限且无任何疼痛。计算机断层扫描（CT）显示右侧冠状突均匀增大。借助内镜系统，通过颞部头皮的两个短切口入路进行了冠状突切除术。标本的组织病理学检查显示骨结构基本正常，无肿瘤证据。作者介绍了内镜辅助下冠状突切除术技术，作为CPH及一般冠状突任何肿物手术治疗的一种替代方法。采用这种方法，切口比传统冠状切口短得多，因此发病率显著降低。
