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The hypothetical role of congenital hypotonia in the development of early coronoid hyperplasia.
[kabuki syndrome]
Coronoid
hyperplasia
(
CH
)
is
an
abnormal
bony
elongation
of
a
histologically
normal
coronoid
process
.
Its
definitive
cause
remains
unknown
.
To
analyze
the
possible
implication
of
congenital
hypotonia
in
the
pathogenesis
of
early
coronoid
overgrowth
.
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
.
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
.
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
.
