# Surgical Treatment of Mandibular Coronoid Process Hypertrophy Syndrome

## TL;DR

This paper shows that removing enlarged jaw bones through surgery and following up with physical therapy improves mouth opening in patients with a rare jaw condition.

## Contribution

The study presents a novel surgical and physiotherapy approach for treating mandibular coronoid process hypertrophy with functional improvements in patients.

## Key findings

- Intraoral coronoidectomy increased mouth opening in all patients.
- Patients with severe restrictions showed greater improvement after surgery.
- Early and intensive physiotherapy is crucial for long-term functional recovery.

## Abstract

Background/Objectives: Mandibular coronoid process hypertrophy (MCPH) is a rare condition characterized by an abnormal enlargement of the mandibular coronoid process, resulting in restricted mouth opening and reduced lateral mandibular movements due to interference with the zygomatic bone. The objective of this paper is to evaluate the functional outcomes of intraoral coronoidectomy followed by physiotherapy in five consecutive patients with MCPH. Methods: Five male patients (mean age 38 ± 18.7 years) with radiologically confirmed bilateral MCPH underwent intraoral coronoidectomy between May 2020 and December 2022. Maximal inter-incisal opening (MIO) was measured pre-operatively, on postoperative day 1, and at 6-month follow-up. A standardized 5-10-60 mouth-opening exercise protocol using a Heister mouth gag was administered from postoperative day 1. Results: The hyperplastic mandibular coronoid processes were removed intraorally without any long-lasting complications. All patients demonstrated a postoperative increase in mouth opening. Notably, patients with more severe mouth-opening limitations showed greater improvement compared with those with milder initial restrictions. Conclusions: Intraoral coronoidectomy, combined with early and intensive physiotherapy, represents a safe and effective treatment for MCPH. Early diagnosis and timely surgical intervention are crucial to prevent ineffective non-surgical management. Additionally, a modest initial postoperative increase in mouth opening should not be considered the final outcome, as these patients often achieve substantial long-term functional improvement.