Coronoid Foramina in a Pediatric Mandible

Abstract

The new advancing technologies have created a storm in the long-existing canons of anatomic sciences with the bandwagon of recent anatomical discoveries such as the existence and identification of a bilateral foramen in the coronoid process of the mandible. The coronoid process being a thin flat triangular process varies in shape and size and gives attachment to the main muscles of mastication the temporalis and the masseter. The excitement of exploratory anatomic victory on mysteries related to the anatomy of the head-and-neck region specific to the coronoid process was further documented and elaborated as an incidental finding. The following manuscript presents an intriguing case of a pediatric patient aged 7 years with a morphologic variation of coronoid process with presence of foramina bilaterally along with few other variants, further attempting to emphasize its occurrence in the developmental years as a possibility of developmental variant trait.

Examination of coronoid foramen and coronoid canal with CBCT

“…The clinical importance of this study is to emphasize that the neurovascular structures inside the coronoid foramen and coronoid canal may be damaged in interventional procedures such as coronoid hyperplasia, coronoid fractures and coronoid graft harvesting [ [21] , [22] , [23] ]. As a result of this study, in parallel with the results of previous studies, it was thought that knowing the presence of the coronoid canal and coronoid foramen would prevent complications that may occur in surgical procedures to be performed [ [16] , [17] , [18] ]. In addition to the occurrence of conditions such as paresthesia, excessive bleeding, and traumatic neuroma as a result of a violation of the structural integrity of these anatomical variations in surgical procedures due to anatomical variations in the body, it has been reported that some anatomical variations may play a role in the spread of tumor cells following radiotherapy [ 24 , 25 ].…”

“…When the literature was reviewed, six studies examining the coronoid foramen in humans were found, however, there is no study examining the frequency of the coronoid canal in humans [ 3 , 13 , [16] , [17] , [18] , [19] ]. Four of these six studies are case report studies.…”

“…In 2023, Ghousia and Firdoose presented a case report in which bilateral coronoid foramen with the coronoid canal on the right side was examined in a pediatric patient. In Ghousia and Firdoose's studies, coronoid foramen and coronoid canal were mentioned for the first time in a pediatric patient [ 18 ].…”

Clinical anatomy of coronoid foramina of mandible and review of its implications in maxillofacial surgery

“…In the present study, we determined the FN as a normal anatomical variation in the coronoid process in human mandibles analyzed radiographically amongst the patients of Saudi origin. A systematic review identi ed only ve studies that reported the prevalence of FN in live humans [11,12,13,15,16]. Most of the foramina and canals continue towards progressive obliteration from birth to the rst year of life [1].…”

“…Continuous studies of human morphology are warranted to understand better this anatomic variation. The youngest patient to date was a 7-year-old boy and the oldest patient was a 75-year-old lady to have the con rmed variation in their mandible, the only other published study of similar variation at such a young age was by Ghousia et al [15]. The study by Gunduz et al was in association with the accessory mandibular foramina in a Turkish population reporting a mere 2% presence of FN in a sample size of 979 radiographs scanned retrospectively [16].…”