title: The hypothetical role of congenital hypotonia in the development of early coronoid hyperplasia.
abstract: BACKGROUND
  Coronoid hyperplasia (CH) is an abnormal bony elongation of a histologically normal coronoid process. Its definitive cause remains unknown.
  
  
  OBJECTIVE
  To analyze the possible implication of congenital hypotonia in the pathogenesis of early coronoid overgrowth.
  
  
  METHODS
  Two infants with congenital hypotonia were evaluated for limited mouth aperture. Bilateral CH was diagnosed. Transoral coronoidectomy was followed by an early dynamic physiotherapy program.
  
  
  RESULTS
  Significant improvement of maximum interincisal opening was achieved. The review of the scientific literature proved the diagnosis of CH in the infant age group is extremely unusual and the etiology of the condition is still uncertain.
  
  
  CONCLUSIONS
  Besides mouth opening restriction, clinical features of coronoid hyperplasia in infants can include suction or deglutition anomalies, failure to thrive and recurrent episodes of choking or aspiration pneumonia. The authors hypothesize reduced fetal mandibular movements and deglutition as a result of congenital hypotonia may lead to relative hyperactivity of the temporalis muscle that is not counterbalanced by the infra and suprahyoid muscles, thereby facilitating coronoid overgrowth.
authors: Department of Oral and Maxillofacial Surgery, Hospital Clínico Universitario of Valencia, 17 Blasco Ibáñez Avenue, 46010 Valencia, Spain.
authors: Miguel
authors: M
authors: Puche
authors: Raquel
authors: R
authors: Guijarro-Martínez
authors: Gonzalo
authors: G
authors: Pérez-Herrezuelo
authors: Luis
authors: L
authors: Miragall
authors: María E
authors: ME
authors: Iglesias
authors: Cecilia
authors: C
authors: Martínez-Costa
mesh_terms: D000015:Abnormalities, Multiple / Q000473:pathology; D001176:Arthrogryposis / Q000473:pathology; D005145:Face / Q000002:abnormalities / Q000473:pathology; D005500:Follow-Up Studies; D005774:Gastrostomy; D006402:Hematologic Diseases / Q000473:pathology; D006801:Humans; D006965:Hyperplasia; D007223:Infant; D008297:Male; D008334:Mandible / Q000473:pathology* / Q000601:surgery; D008410:Masticatory Muscles / Q000473:pathology*; D009123:Muscle Hypotonia / Q000151:congenital*; D026201:Musculoskeletal Manipulations; D016059:Range of Motion, Articular / Q000502:physiology; D014139:Tracheostomy; D015837:Vestibular Diseases / Q000473:pathology