A Novel Approach to Coronoidectomy: the Modified Keen Technique

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Surgical Innovation

Background:

• Coronoid fractures are rare but often associated with significant craniofacial trauma.
• Traditional surgical management typically involves a posterior intraoral approach for coronoidectomy.
• This approach can be challenging for direct visualization and access.

Observation:

• A novel technique utilizing a modified Keen approach for coronoidectomy is presented.
• The approach was applied in a patient with concomitant zygomatico-maxillary complex and coronoid fractures.
• It involves an anterior intraoral incision and subperiosteal dissection.

Findings:

• The modified Keen approach allows direct visualization of the coronoid process without endoscopy.
• This technique facilitates simultaneous fixation of midfacial fractures.
• It utilizes an easily retracted and closed anterior intraoral incision.

Implications:

• The modified Keen approach is a quick and versatile alternative to the classic intraoral coronoidectomy.
• It should be considered for treating trismus when intraoral coronoidectomy is indicated.
• This technique offers potential advantages in managing complex craniofacial fractures.