Benign masseter muscle hypertrophy

Abstract

Idiopathic hypertrophy of the masseter muscle is a rare disorder of unknown cause. Some authors associate it with the habit of chewing gum, temporo-mandibular joint disorder, congenital and functional hypertrophies, and emotional disorders (stress and nervousness). Most patients complain of the cosmetic change caused by facial asymmetry, also called square face, however, symptoms such as trismus, protrusion and bruxism may also occur. The goals of the present investigation were: to report a case of idiopathic masseter hypertrophy, describe its symptoms and treatment. The patient reported bilateral bulging in the region of the mandible angle, of slow and progressive evolution. He did not complain of pain or discomfort, however there was bilateral otalgia, nighttime trismus and stress. In his physical exam we noticed bilateral masseter hypertrophy without local inflammatory alterations. We indicated surgical treatment with an extraoral approach. Complementary tests are indicated when there is diagnostic doubts. Treatment varies from conservative to surgical, and the later depends on surgeon skill and experience.

Obstructive Parotitis Secondary to an Acute Masseteric Bend

“…These lesions can be extremely varied, including vascular malformations, muscle denervation, autoimmune syndromes, juvenile recurrent parotitis, brachial cleft cysts, MMH, bacterial or viral infections, fibrous dysplasia, radiation necrosis, local and metastatic malignant spread, and tumors of the muscle, mandible or salivary glands [3,4] . Of these, MMH is a fairly rare condition with less than 200 reported cases in the literature [5] . Most commonly it is an asymptomatic enlargement of the masseter muscle that can present unilaterally or bilaterally.…”

“…The most common etiology of MMH is due to overuse of the jaws due to clenching, bruxism, constant chewing or temporomandibular joint disorder [5,7] . As a result, MMH has an insidious development over a number of years.…”

“…Treatment of MMH is commonly reserved for severe cases or cases with functional symptoms [5] . The standard approach is to use botulinum toxin type A injections of the masseter muscle to allow for muscle denervation and eventual atrophy.…”

The Bemusing Broadened Face – A Case of Bilateral Masseter Muscle Hypertrophy

“…A hypertrophied masseter will alter facial lines, generating discomfort, and negative cosmetic impacts for many patients [1] . The aetiology of this condition remains obscure, but some authors have correlated it to gum chewing, psychological disorders, and tempo roman dibular joint disorders, to name a few [2] . Hereby, we report a case of a bilateral masseter hypertrophy in a 32-year-old patient, who reported with a complain of unexplained pain on one side of the face.…”

Masseter and medial pterygoid muscle hypertrophy

“…Some patients complain of pain, headache, muscle stress, trismus and intermittent masticatory claudication 8. The radiographic findings associated with MMH are the bone spurs at the angle of mandible6 or flaring of mandibular angle2 and hyperostosis of mandibular ramus 9.…”