Elongated coronoid process: CT-based quantitative analysis of the coronoid process and review of literature

Impingement of the enlarged coronoid processes against the medial surfaces of the zygomatic arches and posterior surfaces of the body of the zygomatic bones results in mechanical restriction of the mouth opening. The authors introduce a helpful tool for easy assessment and estimatation of the length of the coronoid process, measured on the CT scans of 40 patients (20 adults, 20 adolescents) and report a case of a 13-year-old boy suffering from restricted mouth opening caused by bilateral hyperplasia of the coronoid process. The CT based analysis resulted in a mean length of the coronoid process of 13.02 mm in adults and 12.43 mm in adolescents. The 13-year-old boy had a length of nearly 2 cm. For comparison, a coronoid/condyle ratio was developed. This ratio showed a value of 0.78 for all patients compared with a value of about 2.0 for the boy. The literature review revealed comparable results to the reported case. Most of the patients were adolescent, male and presented a median history of 2 years until correct diagnosis.