A 35 year old female with developing class-III malocclusion has asymmetry with chin deviated to left side. On CT bony spicules like mass growing in the direction of lateral pterygoid is due to?
**Core Concept**
The underlying condition described is a class-III malocclusion with chin deviation to the left side, indicating a possible mandibular asymmetry. This is associated with a mass growing in the direction of the lateral pterygoid muscle, suggesting a possible involvement of the coronoid process or the surrounding bone.
**Why the Correct Answer is Right**
The mass is likely a coronoid process fracture or a coronoid process hyperplasia, which is a rare condition. This mass may be displacing the condyle of the mandible, leading to the observed asymmetry and malocclusion. The coronoid process is a thin, triangular bone that articulates with the mandible and helps in the elevation of the mandible during mastication.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because a fibrous dysplasia would typically present as a well-defined lytic lesion with ground-glass appearance on CT, which is not described in this scenario.
**Option B:** This option is incorrect because a myositis or muscle injury would not typically present as a discrete bony mass on CT.
**Option C:** This option is incorrect because an osteoma would be a benign bone tumor, which might not be associated with the observed asymmetry and malocclusion.
**Clinical Pearl / High-Yield Fact**
A key point to remember is that coronoid process hyperplasia or fractures can be a cause of mandibular asymmetry and malocclusion, especially in young adults with a history of trauma or repetitive strain.
**Correct Answer:** D.