Ankylosis of the Coronoid Process to the Zygomatic Bone : A Case Report and Review of the Literature

Publication date: Available online 18 October 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Sang Min Lee, Jin-A. Baek, Yongsoo Kim

Abstract

Purpose

Extra-articular temporomandibular bony ankylosis between the zygomatic bone and coronoid process is a rare condition. Currently, there are <40 cases reported in the English literature. The aim of this study was to report a case of zygomatico-coronoid ankylosis with surgical intervention and a literature review.

Method

Through a PubMed search from 1946 to February 2018, using the terms ("extra-capsular" OR "zygomatico-coronoid" OR "extra-articular") AND ("ankylosis"), 61 articles were initially identified. After screening, manual reviewing, and including additional articles through reviews of the reference lists, 26 reports (33 patients) were finally included in the analysis.

Result

The age of the patients ranged from 12 to 71 years (mean, 36.62 years; S.D., ± 16.24). The gender composition of the patients was as follows: males (n = 20; 60.6%), females (n = 12; 36.4%), and unknown (n = 1; 0.3%), with a clear predominance of male patients. The etiologies were trauma (n = 25; 75.8%), infection (n = 3; 9.1%), surgical complication (n = 4; 12.1%), and radiotherapy for maxillary cancer (SCC; n = 1; 3.0%). The treatment options were surgical intervention via intraoral approach (n = 19; 57.6%), via extraoral approach (n = 10; 30.3%), and via both intraoral and extraoral approach (n = 2; 6.1%), as well as non-surgical intervention (n = 2; 6.1%)

Conclusion

Zygomatico-coronoid ankylosis is one of the possible causes of mouth-opening limitation, particularly in relation to facial trauma. However, it can be easily overlooked because of the rarity of zygomatico-coronoid ankylosis and the attention focused on the joint. Surgical intervention is regarded as a good treatment to improve mouth-opening limitation.

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