Unexplained permanent constriction of the jaws (Langenbeck's disease): about two cases

ANOUAR, TITOU; Faiçal, CHOUMI; Mohammed, MOUMINE

doi:10.21608/OMX.2023.199939.1184

Unexplained permanent constriction of the jaws (Langenbeck's disease): about two cases

Document Type : Case Report

Authors

¹ Department of Head and neck Surgery, Hassan II University Hospital of Fez, Sidi Mohamed Ben Abdellah University Faculty of Medicine and Pharmacy, Fez, Morocco

² Department of Maxillofacial Surgery and Stomatology, Moulay Ismail Military Hospital, Sidi Mohamed Ben Abdellah University Faculty of Medicine and Pharmacy, Meknes, Morocco

10.21608/OMX.2023.199939.1184

Abstract

Introduction Hypertrophy of the coronoid process is a rare pathology, described by Langenbeck in 1853 . This anomaly can be
uni- or bilateral. Two entities have been described with few cases in the literature, which may cause some diagnostic confusion.
Through this work we have highlighted Langenbeck's disease by two cases treated in our department of maxillofacial surgery
and stomatology of the Moulay Ismail military hospital in Meknes.
Observation we report two cases of patients consulting in our service for a chronic limitation of the mouth opening never
followed. In both cases orthopantomogram and CT of the facial bone showed bilateral hyperplasia of the coronoid processes.
Langenbeck's disease was retained as a diagnosis.The treatment for our two cases was based on bilateral resection via the
endobuccal route under general anesthesia with nasotracheal intubation by fibroscopy. The histological study of the surgical
specimens confirmed the diagnosis of Langenbeck's disease.
Discussion Among the bone causes of limitation of mouth opening, hypertrophy of the coronoid process or Langenbeck's
disease is one of the most frequent. Panoramic dental imaging makes it possible to suspect hyperplasia but only 3D CT can
confirm the diagnosis. Langenbeck's disease is an increase in the size of the coronoid process without bony abnormality. It is
usually bilateral. The painless nature of this disease is the reason for the diagnostic delay as for our two cases presented.
Coronoidectomy associated with postoperative maxillofacial physiotherapy is the treatment of choice.

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