Mandibular Limitation Due to Bilateral Coronoid Enlargement: Management by Surgery and Physical Therapy

Limitation of mandibular opening may be a presenting sign in many disorders, and the differential diagnosis of its cause must include consideration of both intra- and extra-articular factors. One possible etiological factor is coronoid enlargement, which can be neoplastic, hyperplastic, or developmental. When coronoid enlargement is present, vigorous management is required to gain and maintain a useful, functional opening excursion. In the case presented here, the opening impedance was removed surgically, but relatively prolonged and concentrated physical therapy was required to effect a cure.