title: [Transoral coronoidectomy: Technical note].
abstract: BACKGROUND
  Among the skeletal causes of limited mouth opening, uni- or bilateral coronoid process hypertrophy, or Langenbeck disease, is the most frequent. It can be associated with an osteochondroma or a coronoid-malar bone conflict and is then called Jacob disease, an unilateral pathology. Treatment rests on coronoidectomy in both cases. This technique is illustrated via two cases, one Langenbeck and one Jacob disease.
  
  
  METHODS
  A transoral approach was performed. After subperiosteal dissection, the coronoid process was cleared. The process was than severed at its base by means of a burr, freed from its temporal muscular fibers and removed. Mouth opening improved peroperatively. The surgical procedure was completed by active long-term physiotherapy beginning immediately after surgery.
  
  
  CONCLUSIONS
  Transoral coronoidectomy is a simple, quick and safe procedure. Extra-oral approaches present a high risk of facial nerve injury. In our first case, mouth opening improved from 24 to 36 mm after bilateral coronoidectomy and to 40 mm after physiotherapy. In our second case, mouth opening improved from 22 to 38 mm after unilateral coronoidectomy and to 43 mm after one year physiotherapy. Long-term post-operative physiotherapy is mandatory to get and maintain good results.
authors.affiliation: Service de stomatologie et de chirurgie maxillo-faciale, hôpital de la Conception, CHU Timone, boulevard Jean-Moulin, 13385 Marseille cedex 5, France; Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, centre hospitalier des Bourrelys, 13015 Marseille, France. Electronic address: jeremygage@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Gagé
authors.affiliation: Service de stomatologie et de chirurgie maxillo-faciale, hôpital de la Conception, CHU Timone, boulevard Jean-Moulin, 13385 Marseille cedex 5, France.
authors.forename: A
authors.initials: A
authors.lastname: Gallucci
authors.affiliation: Service de stomatologie et de chirurgie maxillo-faciale, hôpital de la Conception, CHU Timone, boulevard Jean-Moulin, 13385 Marseille cedex 5, France.
authors.forename: R
authors.initials: R
authors.lastname: Stroumsa
authors.affiliation: Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, centre hospitalier des Bourrelys, 13015 Marseille, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Foletti
authors.affiliation: Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, centre hospitalier des Bourrelys, 13015 Marseille, France.
authors.forename: L
authors.initials: L
authors.lastname: Guyot
authors.affiliation: Service de stomatologie et de chirurgie maxillo-faciale, hôpital de la Conception, CHU Timone, boulevard Jean-Moulin, 13385 Marseille cedex 5, France.
authors.forename: C
authors.initials: C
authors.lastname: Chossegros
mesh_terms: D000844:Ankylosis / Q000209:etiology / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008334:Mandible / Q000502:physiology / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000150:complications / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery; D009059:Mouth Diseases / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods* / Q000534:rehabilitation; D015831:Osteochondroma / Q000150:complications / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D013704:Temporomandibular Joint / Q000473:pathology / Q000502:physiology / Q000601:surgery*; D015050:Zygoma / Q000473:pathology / Q000601:surgery*
keywords: Ankylose; Ankylosis; Articulation temporo-mandibulaire; Maladie de la bouche; Mouth disease; Osteochondroma; Ostéochondrome; Temporo-mandibular joint