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Coronoidectomy (separate procedure)
CPT4 code
#### Coronoidectomy (Separate Procedure)
##### Name of the Procedure:
- **Common Name(s):** Coronoidectomy
- **Medical Term:** Coronoidectomy
##### Summary
A coronoidectomy is a surgical procedure involving the removal of the coronoid process, a small bony prominence of the lower jaw (mandible). This procedure helps restore normal jaw function when the coronoid process is causing problems.
##### Purpose
- **Condition Addressed:** Temporomandibular joint disorders (TMJ), restricted jaw movement, or abnormal bone growth.
- **Goals/Outcomes:** To relieve jaw pain, improve jaw mobility, and correct any structural issues obstructing mouth opening.
##### Indications
- **Symptoms/Conditions:** Difficulty in opening the mouth (trismus), chronic jaw pain, or limited jaw mobility.
- **Patient Criteria:** Patients with radiographic evidence of extended or malformed coronoid process, persistent symptoms not relieved by conservative treatments.
##### Preparation
- **Pre-Procedure Instructions:**
- Fasting for at least 8 hours before surgery.
- Adjusting or discontinuing certain medications as advised by the surgeon.
- **Diagnostic Tests:** Imaging studies like X-rays, CT scans, or MRI of the jaw to assess the coronoid process.
##### Procedure Description
1. **Anesthesia:** General anesthesia is administered for comfort and to keep the patient immobile.
2. **Incision:** An incision is made in the oral mucosa inside the mouth or externally on the face to access the jawbone.
3. **Resection:** The surgeon uses specialized surgical tools to remove the coronoid process.
4. **Closure:** The incision is closed with sutures, and sometimes drains are placed to prevent fluid accumulation.
##### Duration
Typically, the procedure takes about 1 to 2 hours.
##### Setting
Performed in a hospital or surgical center under sterile conditions.
##### Personnel
- **Surgeon:** An oral and maxillofacial surgeon.
- **Nurses:** Assisting in the operating room.
- **Anesthesiologist:** Administering anesthesia and monitoring vital signs.
##### Risks and Complications
- **Common Risks:** Infection, bleeding, swelling, pain.
- **Rare Risks:** Nerve damage, jaw stiffness, adverse reaction to anesthesia. Complications are managed with medication, physical therapy, or additional surgery if needed.
##### Benefits
- **Expected Benefits:** Reduced pain, improved jaw mobility. Benefits are typically realized within weeks post-surgery.
##### Recovery
- **Post-Procedure Care:** Pain management with prescribed medications, soft diet, regular follow-up visits.
- **Recovery Time:** Initial recovery within 2 weeks, with full recovery in about 6 weeks. Avoid strenuous activities and follow dietary restrictions as advised.
##### Alternatives
- **Other Treatments:** Physical therapy, medications (analgesics, muscle relaxants), less invasive surgical procedures (coronoidotomy).
- **Pros and Cons:** Alternatives may offer temporary relief and less recovery time but may not resolve severe structural issues as effectively as a coronoidectomy.
##### Patient Experience
- **During Procedure:** The patient will be under general anesthesia and will not feel pain.
- **After Procedure:** Post-surgical pain managed with medications. Temporary facial swelling and limited jaw movement expected. Comfort measures include ice packs, soft diet, and prescribed analgesics.