CORONOIDOTOMY VERSUS CORONOIDECTOMY
The “coronoid process of the mandible” is a vertical prominence at the back end of the lower jaw just in front of the jaw joints on both sides. It develops as an attachment for the temporalis muscle which is one of the main paired closing and clenching muscles of the jaw. It is also the main muscle that we see involved in jaw muscle dysfunction, also known as TMD and TMJ.
Coronoidotomy is a procedure where the base attachment to the muscle is cut, but the bone piece is left in place. Coronoidectomy is a procedure where the bone attachment is cut and removed (J Oral Maxillofac Surg 75:1263-1273, 2017). That is a more involved procedure, but is generally felt to be a “better” “more complete” procedure. Because the coronoidectomy is more complicated and more expensive the insurers are more likely to push for the less expensive coronoidotomy. I am willing to discuss the options on a case by case basis, but by-and-large the coronoidectomy is a much better, long-term stable result, definitive procedure. Especially if my patient is a younger, active person who has already dealt with complex, long-standing concerns. If the procedure is needed, let’s do it comprehensively.
Of course every patient has their individual wants, needs, and desires. As a surgeon you present the information and options and try to tailor a procedure that will best serve their needs.
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