Masseter muscle hypertrophy: A case report

Maruyama, Satoshi; Yamazaki, Manabu; Niimi, Keiko; Kobayashi, Tadaharu; Nishiyama, Hiroaki; Hayshi, Takafumi; Tanuma, Jun‐ichi

doi:10.1016/j.ajoms.2019.08.005

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…The histopathological findings of this case revealed hyperplasia of thick muscle cells with diameters of approximately 60 μm, while normal cells were in the range of 20–40 μm as previously reported by Tsuneki et al [ 9 ]. Masseter muscle hypertrophy is a relatively rare and benign enlargement of the unilateral or bilateral masseter muscles [ 10 ].…”

Section: Discussionsupporting

confidence: 84%

Masticatory muscle tendon-aponeurosis hyperplasia that was initially misdiagnosed for polymyositis: a case report and review of the literature

Katagiri

Saito

Maruyama

et al. 2023

Maxillofac Plast Reconstr Surg

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Background Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a relatively newly identified clinical condition that manifests as trismus with a square-shaped mandible. Herein, we report a case of MMATH that was initially misdiagnosed for polymyositis due to trismus and simultaneous lower limb pain, with literature review. Case presentation A 30-year-old woman had a history of lower limb pain after exertion for 2 years. Initial physical examination had been performed at the Department of General Medicine in our hospital. There was also redness in the hands and fingers. Although polymyositis was suspected, it was denied. The patient visited our department for right maxillary wisdom tooth extraction. Clinical examination revealed that the patient had a square-shaped mandible. The maximal mouth opening was 22 mm. There was no temporomandibular joint pain at the time of opening. Furthermore, there was awareness of clenching while working. Panoramic radiography revealed developed square mandibular angles with flattened condyles. Computed tomography showed enlarged masseter muscles with high-density areas around the anterior and lateral fascia. Magnetic resonance imaging also showed thickened tendons and aponeuroses on the anterior surface and inside bilateral masseter muscles. Finally, the patient was diagnosed with MMTAH. Bilateral aponeurectomy of the masseter muscles with coronoidectomy and masseter muscle myotomy was performed under general anesthesia. The maximum opening during surgery was 48 mm. Mouth opening training was started on day 3 after surgery. Histopathological examination of the surgical specimen showed that the muscle fibers were enlarged to 60 μm. Immunohistochemistry testing for calcineurin, which was associated with muscle hypertrophy due to overload in some case reports, showed positive results. Twelve months after surgery, the mouth self-opening and forced opening were over 35 mm and 44 mm, respectively. Conclusions Herein, we report a case of MMATH. Lower limb pain due to prolonged standing at work and overload due to clenching were considered risk factors for symptoms onset of MMATH.

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Section: Discussionsupporting

confidence: 84%

Masticatory muscle tendon-aponeurosis hyperplasia that was initially misdiagnosed for polymyositis: a case report and review of the literature

Katagiri

Saito

Maruyama

et al. 2023

Maxillofac Plast Reconstr Surg

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“…On histological evaluation, the benign nature of the condition was demonstrated for the presented case; the serial histological sections showed hypertrophied striated skeletal muscle with well-preserved architecture, but no evidence of interstitial inflammation. In previous reports, histological examination of specimens from patients with masseter muscle hypertrophy demonstrated substantial hypertrophy with a muscle fiber diameter increase more than two to three times that of normal muscle fibers [ 36 , 37 ]. These results are in line with what we found in our case report but in slight contradiction with the Trujillo et al statement that “microscopic examination of the removed muscle tissue usually shows normal muscle fibers without changes in length, thickness, or nuclear structure” [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Unusual Case of Masseter Muscle Hypertrophy in Adolescence—Case Report and Literature Overview

et al. 2022

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Unilateral hypertrophy of the masseter muscle is a very rare pathological entity in children. Its etiology is uncertain and it requires a high degree of suspicion, as it must be differentiated from other conditions of the masseter area. As there are few pathological studies to elucidate this condition, we report a rare case of unilateral masseter muscle hypertrophy in a 16-year-old female patient with gradual onset of a painless swelling in the posterior left cheek which caused facial asymmetry with repercussions on the patient’s self-image. The diagnosis of unilateral masseter muscle hypertrophy was suggested by clinical examination, ultrasound scanning, and nuclear magnetic resonance, and was confirmed by histologic examination two years later when the patient returned for the surgical correction. The pathological findings report showed fragments of skeletal muscle with hypertrophic fibers associated with normal-sized muscle fibers in both longitudinal and transverse sections. The postoperative evaluation was favorable as both the adolescent and her family were satisfied with her look on the 14th day, 1st year, and 3rd year follow-ups. In conclusion, unilateral masseter muscle hypertrophy in adolescence is a sensitive problem due to the psychological implications of facial appearance. Definite diagnosis and treatment of the hypertrophied muscle is the ideal solution.

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“…Yüz germe işlemi, genişlemiş ya da büyümüş bir m.masseter ya da m.masseter'in herhangi bir lezyonu m.masseter'e uygulanacak cerrahi bir işlemi gerektirebilir. M.masseter'in kritik yerleşiminden dolayı yapılacak bir müdahalede özellikle m.risorius'a ait liflere ve n.facialis'e ait sinir dallarına zarar verilmemesine özen gösterilmelidir [8][9][10][11][12] . M.masseter'in klinik yönden önemli olduğu diğer bir alan da çene kaslarının sertliği olarak bilinen ve çelik çene olarak ifade edilen masseter kas rijiditesi'dir.…”

Section: Geçmişten Günümüze Masseter Kasının Fonksiyonel Anatomisiunclassified

Masseter kası yeni bir parça Anatomi ve Embriyolojisi: Pars coronoidea tartışması

ÖZANDAÇ POLAT,

KARA

2023

Arşiv Kaynak Tarama Dergisi

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Dörtgen şeklinde kalın bir kas olan masseter kasının en temel görevi mandibula’yı maxilla’ya karşı eleve etmek, dişlerin ısırma ve çiğneme işlevlerini gerçekleştirmek suretiyle çeneyi kapatmaktır. Lateral hareketlerde ve mandibula protraksiyonunda az da olsa görev alan masseter kası, esasen yüz estetiğinde oldukça önem arz eden dört çiğneme kasından biridir. Aralık 2021’de Mezey ve ark.ları tarafından yayınlanan bir makalede, anatomik olarak, masseter kasına ait derin farklı üçüncü bir tabakanın os temporale processus zygomaticus medial yüzeyinden, coronoideus posterior kenarına ve köküne doğru uzandığı gösterildi. Masseter pars coronoidea olarak adlandırılan bu yapının masseter kasına ait üçüncü ve yeni bir parça olduğu ileri sürüldü. Bu çalışma, bilim dünyasında oldukça ilgi çekici bulunduğu kadar, beraberinde bazı soru işaretlerinin varlığını da gündeme getirmiş ve tepkilere neden olmuştur. Sunulan bu çalışmada, geçmişten günümüze masseter kasının, embriyolojik gelişimleri ile anatomik ve histolojik yapılarının güncel bilgiler ışığında gözden geçirilmesi ve yeni bir tanımlama olarak bilim dünyasına sunulan masseter kası ile ilgili tartışmanın tüm yönleriyle ele alınması amaçlandı.

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Masseter muscle hypertrophy: A case report

Cited by 5 publications

References 13 publications

Masticatory muscle tendon-aponeurosis hyperplasia that was initially misdiagnosed for polymyositis: a case report and review of the literature

Masticatory muscle tendon-aponeurosis hyperplasia that was initially misdiagnosed for polymyositis: a case report and review of the literature

Unusual Case of Masseter Muscle Hypertrophy in Adolescence—Case Report and Literature Overview

Masseter kası yeni bir parça Anatomi ve Embriyolojisi: Pars coronoidea tartışması

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