coronoidectomy

Coronoidectomy is a surgical procedure that involves the removal of the coronoid process of the mandible. The coronoid process is a triangular bony projection on the anterior part of the mandibular ramus, serving as the attachment for the temporalis muscle. Removal is performed to relieve mechanical obstruction to mouth opening when the coronoid becomes elongated or hyperplastic, or when a lesion such as osteochondroma causes impingement against the zygomatic arch or surrounding structures.

Indications include persistent trismus with radiographic or clinical evidence of coronoid hyperplasia or other coronoid-based lesions, posttraumatic malformations, or rare bony tumors. The procedure can be performed unilaterally or bilaterally and is often part of a broader management plan for restricted jaw mobility. The choice of approach depends on the size, location, and accessibility of the coronoid process and the surgeon’s preference.

Techniques are most commonly performed via an intraoral approach to avoid facial scarring, with resection of all or part of the coronoid process while preserving the mandible’s structural integrity. In some cases, an extraoral approach is used when access is limited or high coronoid processes are involved, though this carries a greater risk of facial scarring and nerve injury.

Outcomes are generally favorable, with improved maximal mouth opening and function in many patients. Potential complications include hematoma, infection, injury to branches of the facial or inferior alveolar nerves, temporomandibular joint injury, recurrence of trismus, mandibular fracture, and cosmetic concerns from scarring in extraoral approaches.