Clinical and magnetic resonance imaging imaging analysis of hyperplasia of the coronoid process

doi:10.3877/cma.j.issn.1674-1366.2024.03.005

Abstract

Abstract:

Objective

Our objective was to conduct a comprehensive analysis of the clinical symptoms and magnetic resonance imaging (MRI) findings in two adult patients with hyperplasia of the coronoid process (CPH) .

Methods

A retrospective study was conducted, analyzing two patients clinically diagnosed with an elongated coronoid process (CPH group) , along with MRI data from 100 normal joints of 71 patients diagnosed with temporomandibular joint disorders (control group) . All participants underwent temporomandibular joint examination using a 3.0T MRI device. The obtained images were post-processed using pyradiomics software to extract muscle texture feature parameters, and a comparative analysis using the Mann-Whitney U test was performed between the two groups.

Results

Both patients with an elongated coronoid process exhibited traits of a low-angle, wide face type, with mouth opening degrees of 20 mm and 22 mm, respectively, and no improvement in passive mouth opening. The pattern of mouth opening remained normal, with no clicking or pain in the joint area. Intraoral examination revealed an endoclination deep bite of the anterior teeth and wear on the posterior teeth. MRI results showed an increase in the volume of the temporal and masseter muscles, with a normal disc-condyle relationship, but degenerative changes in the articular disc and a smooth and continuous surface of the condylar bone. In the elongated coronoid process group, the energy, total energy, gray-level non-uniformity, grid volume and voxel volume of the temporal and masseter muscles were significantly higher than those in the control group (P<0.05) . However, these parameters for the external pterygoid muscle showed no statistically significant difference compared to the control group (P>0.05) .

Conclusions

The MRI imaging of two adult patients with an elongated coronoid process showed an increased volume of the temporal and masseter muscles. This finding was significant for understanding the pathogenic mechanism of CPH.

Key words: Coronoid process hyperplasia, Temporal muscle, Masseter muscle, Magnetic resonance imaging (MRI)

Haixiang Chen, Yuanyin Wang, Pan Jiang. Clinical and magnetic resonance imaging imaging analysis of hyperplasia of the coronoid process[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2024, 18(03): 169-174.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhkqyxyjzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-1366.2024.03.005

https://zhkqyxyjzz.cma-cmc.com.cn/EN/Y2024/V18/I03/169

Figures/Tables 4

References 30

[1]	Parmentier GIL，Nys M，Verstraete L，et al. A systematic review of treatment and outcomes in patients with mandibular coronoid process hyperplasia[J]. J Korean Assoc Oral Maxillofac Surg，2022，48（3）：133-148. DOI：10.5125/jkaoms.2022.48.3.133.
[2]	Mulder CH，Kalaykova SI，Gortzak RA. Coronoid process hyperplasia：A systematic review of the literature from 1995[J]. Int J Oral Maxillofac Surg，2012，41（12）：1483-1489. DOI：10.1016/j.ijom.2012.03.029.
[3]	Costa YM，Porporatti AL，Stuginski-Barbosa J，et al. Coronoid process hyperplasia：An unusual cause of mandibular hypomobility[J]. Braz Dent J，2012，23（3）：252-255. DOI：10.1590/s0103-64402012000300012.
[4]	Goh YC，Tan CC，Lim D. Coronoid hyperplasia：A review[J]. J Stomatol Oral Maxillofac Surg，2020，121（4）：397-403. DOI：10.1016/j.jormas.2019.12.019.
[5]	Chakranarayan A，Jeyaraj P. Coronoid hyperplasia in chronic progressive trismus[J]. Med Hypotheses，2011，77（5）：863-868. DOI：10.1016/j.mehy.2011.07.058.
[6]	Erdem S，Erdem S. Investigation of coronoid process hyperplasia using Levandoski analysis on panoramic radiographs[J]. World J Radiol，2022，14（5）：107-113. DOI：10.4329/wjr.v14.i5.107.
[7]	Leonardi R，Caltabiano M，Lo ML，et al. Bilateral hyperplasia of the mandibular coronoid processes in patients with nevoid basal cell carcinoma syndrome：An undescribed sign[J]. Am J Med Genet，2002，110（4）：400-403. DOI：10.1002/ajmg.10432.
[8]	Bayar GR，Akcam T，Gulses A，et al. An excessive coronoid hyperplasia with suspected traumatic etiology resulting in mandibular hypomobility[J]. Cranio，2012，30（2）：144-149. DOI：10.1179/crn.2012.021.
[9]	Romano M，Porcellini G，Rossi D，et al. Bilateral coronoid hyperplasia：A report of six cases[J]. J Biol Regul Homeost Agents，2017，31（2 Suppl 1）：139-145.
[10]	Kim SM，Lee JH，Kim HJ，et al. Mouth opening limitation caused by coronoid hyperplasia：A report of four cases[J]. J Korean Assoc Oral Maxillofac Surg，2014，40（6）：301-307. DOI：10.5125/jkaoms.2014.40.6.301.
[11]	张艳艳，刘飞，沈颉飞，等.双侧冠突过长导致开口受限2例[J].华西口腔医学杂志，2022，40（4）：476-482. DOI：10.7518/hxkq.2022.04.016.
[12]	廖文婷，何一青，孙佳栋，等.冠突过长：一种伪装成颞下颌关节疾病的罕见病[J/OL].中华口腔医学研究杂志（电子版），2021，15（1）：1-5. DOI：10.3877/cma.j.issn.1674-1366.2021.01.001.
[13]	Colquhoun A，Cathro I，Kumara R，et al. Bilateral coronoid hyperplasia in two brothers[J]. Dentomaxillofac Radiol，2002，31（2）：142-146. DOI：10.1038/sj.dmfr.4600672.
[14]	Galie M，Consorti G，Tieghi R，et al. Early surgical treatment in unilateral coronoid hyperplasia and facial asymmetry[J]. J Craniofac Surg，2010，21（1）：129-133. DOI：10.1097/SCS.0b013e3181c46a30.
[15]	Izumi M，Isobe M，Toyama M，et al. Computed tomographic features of bilateral coronoid process hyperplasia with special emphasis on patients without interference between the process and the zygomatic bone[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod，2005，99（1）：93-100. DOI：10.1016/j.tripleo.2004.04.013.
[16]	Fernández Ferro M，Fernández Sanromán J，Sandoval Gutierrez J，et al. Treatment of bilateral hyperplasia of the coronoid process of the mandible. Presentation of a case and review of the literature[J]. Med Oral Patol Oral Cir Bucal，2008，13（9）：E595-E598.
[17]	Farronato M，Lucchina AG，Mortellaro C，et al. Bilateral hyperplasia of the coronoid process in pediatric patients：What is the gold standard for treatment？[J]. J Craniofac Surg，2019，30（4）：1058-1063. DOI：10.1097/SCS.0000000000004768.
[18]	Pregarz M，Fugazzola C，Consolo U，et al. Computed tomography and magnetic resonance imaging in the management of coronoid process hyperplasia：Review of five cases[J]. Dentomaxillofac Radiol，1998，27（4）：215-220. DOI：10.1038/sj/dmfr/4600353.
[19]	Akita K，Fukino K. The significance and classification of the layered structures of the human masseter and temporalis[J]. Ann Anat，2022，242：151907. DOI：10.1016/j.aanat.2022.151907.
[20]	Gaudy JF，Zouaoui A，Bravetti P，et al. Functional anatomy of the human temporal muscle[J]. Surg Radiol Anat，2001，23（6）：389-398. DOI：10.1007/s00276-001-0389-z.
[21]	樊文萍，刘梦琦，邹颖，等.颞下颌关节紊乱病患者翼外肌MRI直方图纹理特征分析[J].中华口腔医学杂志，2020，55（12）：963-968. DOI：10.3760/cma.j.cn112144-20200514-00274.
[22]	宋文龙，郭大静，陈倩羽，等.基于MR增强图像肝细胞癌直方图纹理分析[J].放射学实践，2019，34（12）：1348-1353. DOI：10.13609/j.cnki.1000-0313.2019.12.014.
[23]	吴晓枫.基于MR增强图像全瘤直方图分析鉴别诊断腮腺Warthin瘤与多形性腺瘤[J].现代医用影像学，2022，31（6）：991-994. DOI：10.3969/j.issn.1006-7035.2022.06.001.
[24]	Tharmaseelan H，Rotkopf LT，Ayx I，et al. Evaluation of radiomics feature stability in abdominal monoenergetic photon counting CT reconstructions[J]. Sci Rep，2022，12（1）：19594. DOI：10.1038/s41598-022-22877-8.
[25]	Suhail P，Bhattacharjee R，Singh A，et al. Radiomics-based evaluation and possible characterization of dynamic contrast enhanced（DCE）perfusion derived different sub-regions of Glioblastoma[J]. Eur J Radiol，2023，159：110655. DOI：10.1016/j.ejrad.2022.110655.
[26]	Yoda T. Masticatory muscle tendon-aponeurosis hyperplasia accompanied by limited mouth opening[J]. J Korean Assoc Oral Maxillofac Surg，2019，45（4）：174-179. DOI：10.5125/jkaoms.2019.45.4.174.
[27]	Elsayed N，Shimo T，Harada F，et al. Masticatory muscle tendon-aponeurosis hyperplasia diagnosed as temporomandibular joint disorder：A case report and review of literature[J]. Int J Surg Case Rep，2021，78：120-125. DOI：10.1016/j.ijscr.2020.11.150.
[28]	Omami G，Miller CS. Imaging evaluation of the temporomandibular joint[J]. Dent Clin North Am，2024，68（2）：357-373. DOI：10.1016/j.cden.2023.10.001.
[29]	Shen YW，Shih YH，Fuh LJ，et al. Oral submucous fibrosis：A review on biomarkers，pathogenic mechanisms，and treatments[J]. Int J Mol Sci，2020，21（19）：7231. DOI：10.3390/ijms21197231.
[30]	Nishi TM，Yamashita S，Hirakawa YN，et al. Proliferative fasciitis/myositis involving the facial muscles including the masseter muscle：A rare cause of trismus[J]. Am J Case Rep，2019，20：1411-1417. DOI：10.12659/AJCR.917193.

组别	侧数	颞肌
组别	侧数	能源（10⁶）	总能量（10⁷）	灰度不均匀性	网格体积（mm³）	体素体积（mm³）
正常对照组	100	282 ± 82	760 ± 222	90 ± 28	6 877 ± 2 247	7 500 ± 2 215
冠突过长组	4	457 ± 218	1 234 ± 588	137 ± 47	11 683 ± 5 543	12 231 ± 5 771
Z值		-3.350	-3.350	-3.186	-3.473	-3.363
P值		0.001	0.001	0.001	0.001	0.001
组别	侧数	咬肌
组别	侧数	能源（10⁶）	总能量（10⁷）	灰度不均匀性	网格体积（mm³）	体素体积（mm³）
正常对照组	100	273 ± 83	737 ± 224	80 ± 19	7 005 ± 2 198	7 310 ± 2 226
冠突过长组	4	362 ± 215	977 ± 580	92 ± 52	9 404 ± 5 613	9 707 ± 5 730
Z值		-2.680	-2.680	-2.338	-2.762	-2.700
P值		0.007	0.007	0.019	0.006	0.007
组别	侧数	翼外肌
组别	侧数	能源（10⁶）	总能量（10⁷）	灰度不均匀性	网格体积（mm³）	体素体积（mm³）
正常对照组	100	223 ± 45	602 ± 12	70 ± 11	5 739 ± 1 181	5 984 ± 1 196
冠突过长组	4	224 ± 35	605 ± 10	74 ± 6	5 793 ± 920	6 021 ± 952
Z值		-0.766	-0.766	-1.155	-0.793	-0.773
P值		0.444	0.444	0.248	0.428	0.440

组别	侧数	颞肌
组别	侧数	能源（10⁶）	总能量（10⁷）	灰度不均匀性	网格体积（mm³）	体素体积（mm³）
正常对照组	100	282 ± 82	760 ± 222	90 ± 28	6 877 ± 2 247	7 500 ± 2 215
冠突过长组	4	457 ± 218	1 234 ± 588	137 ± 47	11 683 ± 5 543	12 231 ± 5 771
Z值		-3.350	-3.350	-3.186	-3.473	-3.363
P值		0.001	0.001	0.001	0.001	0.001
组别	侧数	咬肌
组别	侧数	能源（10⁶）	总能量（10⁷）	灰度不均匀性	网格体积（mm³）	体素体积（mm³）
正常对照组	100	273 ± 83	737 ± 224	80 ± 19	7 005 ± 2 198	7 310 ± 2 226
冠突过长组	4	362 ± 215	977 ± 580	92 ± 52	9 404 ± 5 613	9 707 ± 5 730
Z值		-2.680	-2.680	-2.338	-2.762	-2.700
P值		0.007	0.007	0.019	0.006	0.007
组别	侧数	翼外肌
组别	侧数	能源（10⁶）	总能量（10⁷）	灰度不均匀性	网格体积（mm³）	体素体积（mm³）
正常对照组	100	223 ± 45	602 ± 12	70 ± 11	5 739 ± 1 181	5 984 ± 1 196
冠突过长组	4	224 ± 35	605 ± 10	74 ± 6	5 793 ± 920	6 021 ± 952
Z值		-0.766	-0.766	-1.155	-0.793	-0.773
P值		0.444	0.444	0.248	0.428	0.440

Please choose a citation manager

Content to export