Spontaneous Zygomatic Remodelling after Coronoidectomy in Coronoid Process Hyperplasia and Jacob's Disease - A Case...

Jacob's disease associated with true coronoid hyperplasia (CH) is a rare condition characterized by a pseudo-joint between the coronoid process and the zygomatic arch. Malar asymmetry resulting from zygomatic bone deformation has been reported, but long-term morphological outcomes are seldom documented.

A 13-year-old boy presented with progressive restriction of maximal incisal opening (MIO) of 20 mm and zygomatic asymmetry.

Computed tomography (CT) scan and histopathological examination confirmed the diagnosis of Jacob's disease with CH.

An intraoral coronoidectomy was performed, followed by a structured program of jaw-stretching exercises.

The patient achieved a sustained improvement in MIO. A CT scan at 17 months showed spontaneous zygoma remodeling with resolution of facial asymmetry.

Coronoidectomy with physical therapy can restore MIO effectively. This is the first report of spontaneous correction of zygomatic asymmetry, suggesting the appropriateness of an expectant attitude in this clinical scenario.