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Wang W. Congenital mandibular coronoid process hyperplasia and associated diseases. Oral Dis 2023; 29:2438-2448. [PMID: 36214115 DOI: 10.1111/odi.14400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/27/2022] [Accepted: 10/07/2022] [Indexed: 11/26/2022]
Abstract
Coronoid process hyperplasia (CPH) is an oral and maxillofacial surgical disease that can result in restricted jaw movement due to an enlarged and elongated mandibular coronoid process. It is characterized by the painless progressive restriction of unilaterally or bilaterally mouth opening. Clinically, unexplained bilateral CPH is less common and therefore often overlooked or misdiagnosed, and coronoidectomy can be very effective on improving mouth opening. Currently, the exact etiology and mechanism of congenital CPH have not yet been fully understood, but it is generally believed to be genetically related. In this paper, the relationship of the congenital mandibular CPH with the related diseases was examined based on cases collected in our clinic and literature review for the clinical diagnosis and treatment of patients with restricted mouth opening associated with CPH.
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Affiliation(s)
- Weihong Wang
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
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2
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Tajima R, Okazaki A, Sato T, Ozaki K, Motooka D, Okazaki Y, Yoda T. Genetic Landscape of Masticatory Muscle Tendon-Aponeurosis Hyperplasia. Genes (Basel) 2023; 14:1718. [PMID: 37761858 PMCID: PMC10530891 DOI: 10.3390/genes14091718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Limited mouth opening is a characteristic of masticatory muscle tendon-aponeurosis hyperplasia (MMTAH). Although genetic involvement is suspected where familial onset is frequently observed, the genetic background of MMTAH is yet to be elucidated. In this study, we conducted whole genome sequencing of 10 patients with MMTAH and their family members when available. We also conducted RNA sequencing of normal temporal tendon (as disease region) and Achilles tendon (as control region) from commercially available pig samples. We identified 51 genes that had rare variants in patients with MMTAH and were highly expressed in the temporal tendons of pigs. Among the 51 genes, 37 genes have not been reported to be causative for human genetic diseases so far. As an implication of genetic involvement in the pathogenesis of MMTAH, 21 of these 37 genes were identified in two independent families. In particular, PCDH1 and BAIAP3 were identified in one affected individual in a family and consistently segregated in unrelated family, indicating they could be candidate causative genes of MMTAH. Our findings will help elucidate the genetic landscape of MMTAH and provide insights into future possibilities for tendon regeneration treatment.
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Affiliation(s)
- Rina Tajima
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan;
| | - Atsuko Okazaki
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan;
| | - Tsuyoshi Sato
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun 350-0495, Saitama, Japan;
| | - Kokoro Ozaki
- Laboratory for Comprehensive Genomic Analysis, RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama 230-0045, Kanagawa, Japan;
| | - Daisuke Motooka
- Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Suita 565-0871, Osaka, Japan;
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Suita 565-0871, Osaka, Japan
| | - Yasushi Okazaki
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan;
- Laboratory for Comprehensive Genomic Analysis, RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama 230-0045, Kanagawa, Japan;
| | - Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan;
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Katagiri W, Saito D, Maruyama S, Ike M, Nisiyama H, Hayashi T, Tanuma JI, Kobayashi T. Masticatory muscle tendon-aponeurosis hyperplasia that was initially misdiagnosed for polymyositis: a case report and review of the literature. Maxillofac Plast Reconstr Surg 2023; 45:18. [PMID: 37126217 PMCID: PMC10151447 DOI: 10.1186/s40902-023-00386-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/26/2023] [Indexed: 05/02/2023] Open
Abstract
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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Affiliation(s)
- Wataru Katagiri
- Department of Oral and Maxillofacial Surgery, Gifu University Graduate School of Medicine, Yanagido, Gifu, 501-1194, Japan.
| | - Daisuke Saito
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Science, Niigata University, 2-5274 Gakkocho-dori, Chuo-Ku, Niigata, 951-8514, Japan
| | - Satoshi Maruyama
- Oral Pathology Section, Department of Surgical Pathology, Niigata University Hospital, 1-754 Asahimachi-Dori, Chuo-Ku, Niigata, 951-8520, Japan
| | - Makiko Ike
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-Dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Hideyoshi Nisiyama
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-Dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Takafumi Hayashi
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-Dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Jun-Ichi Tanuma
- Division of Oral Pathology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-dori, Chuo-Ku, Niigata, 951-8514, Japan
| | - Tadaharu Kobayashi
- Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Science, Niigata University, 2-5274 Gakkocho-dori, Chuo-Ku, Niigata, 951-8514, Japan
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Yoshida K. [Therapeutic strategies for oromandibular dystonia]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 89:562-572. [PMID: 33638139 DOI: 10.1055/a-1375-0669] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Oromandibular dystonia is characterized by tonic or clonic involuntary spasms of the masticatory, lingual and / or muscles in the stomatognathic system. It is often misdiagnosed as craniomandibular dysfunction or psychiatric disease. According to clinical features, the oromandibular dystonia is classified into 6 subtypes (jaw closing-, jaw opening-, tongue-, jaw deviation-, jaw protrusion-, and lip dystonia). There are several treatment methods like botulinum toxin injection, muscle afferent block (injection of lidocaine and alcohol into the masticatory or tongue muscles for blocking muscle afferents from muscle spindle), occlusal splint, and oral surgery (coronoidotomy). Most of patients can be treated successfully according to subtype by combination of these treatments. Special treatment recommendations for each subtype were described in this focus article. Accurate diagnosis and treatment of oral dystonia requires comprehensive knowledge and skills of both oral and maxillofacial surgery and neurology. Therefore, collaboration among these departments is very important.
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Affiliation(s)
- Kazuya Yoshida
- Department of Oral and Maxillofacial Surgery, National Hospital Organization, Kyoto Medical Center
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Masticatory muscle tendon-aponeurosis hyperplasia diagnosed as temporomandibular joint disorder: A case report and review of literature. Int J Surg Case Rep 2020; 78:120-125. [PMID: 33340978 PMCID: PMC7750134 DOI: 10.1016/j.ijscr.2020.11.150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 11/30/2020] [Accepted: 11/30/2020] [Indexed: 11/20/2022] Open
Abstract
MMTAH is a new clinical entity, misdiagnosed as temporomandibular joint disorder. MMTAH is diagnosed based on a square mandible, cord-like masseter muscle aponeurosis, and limited mouth-opening. Aponeurectomy combined with coronoidectomy is the treatment of choice for a better prognosis. It is important to evaluate the patient’s compliance with mouth-opening training before surgery.
Introduction Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a new clinical entity that presents mainly with trismus due to hyperplasia of the masseter aponeurosis and temporalis muscle tendon. However, the etiological factors of this disease are unknown; it is often mistreated as temporomandibular joint disorder (TMD). Presentation of case We report a 32-year-old female patient complaining of bilateral pain in her jaw and difficulty opening her mouth. She was first diagnosed as TMD and treated with a splint; however, her symptoms did not improve. Clinical examination revealed a square mandible, tenderness in the left and right temporalis muscles and masseter muscles, and tenderness along the anterior border of the masseter muscle. Her maximum mouth-opening was 30 mm. Short TI inversion recovery magnetic resonance imaging showed areas of low intensity at the anterior border of the masseter muscle and around the coronoid process where the temporalis muscle tendon attaches. Consequently, the diagnosis made based on the clinical and radiographic findings was MMTAH. Bilateral coronoidectomy was performed, followed by a rehabilitation program for six months. The maximum opening was maintained at 48 mm two years after the operation. Discussion MMTAH was treated as type 1 TMD until it was recognized as a new disease at the conference for the Japanese Society for Oral and Maxillofacial Surgeons. Since then, many clinicians have become aware of this particular condition, and different treatment modalities have been proposed. Conclusion Clinicians should consider MMTAH as a differential diagnosis when the patient’s chief complaint is gradually decreasing mouth-opening.
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Yoda T. Masticatory muscle tendon-aponeurosis hyperplasia accompanied by limited mouth opening. J Korean Assoc Oral Maxillofac Surg 2019; 45:174-179. [PMID: 31508348 PMCID: PMC6728625 DOI: 10.5125/jkaoms.2019.45.4.174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 08/12/2019] [Indexed: 11/30/2022] Open
Abstract
Patients with masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) experience limited mouth opening due to restricted muscle extension. Hyperplastic aponeurosis and tendons lead to the restriction of muscle extension. The criteria for the diagnosis of MMTAH are limited mouth opening that progresses very slowly from adolescence, intraoral palpation reveals a hard cord-like structure along the overhang of the anterior border of the masseter muscle on maximum mouth opening, and a square mandible. Conservative treatment, including pharmacotherapy, occlusal splint and physical therapy are ineffective. The standard therapy is surgical treatment, such as anterior partial aponeurectomy of the masseter muscle and coronoidectomy. The long-term results are very satisfying.
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Affiliation(s)
- Tetsuya Yoda
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Lan T, Liu X, Liang PS, Tao Q. Osteochondroma of the coronoid process: A case report and review of the literature. Oncol Lett 2019; 18:2270-2277. [PMID: 31452728 PMCID: PMC6676659 DOI: 10.3892/ol.2019.10537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 05/13/2019] [Indexed: 01/27/2023] Open
Abstract
Osteochondroma (OC) is considered the most common tumor of the axial skeleton, although it is relatively uncommon in the craniofacial region. The present study describes an atypical case of OC of the coronoid process. A 34-year-old woman presented with severely limited mouth opening (5 mm) and swelling of the right zygoma. Cone-beam computed tomography (CBCT) revealed a mushroom-shaped outgrowth from the coronoid process to the inner surface of the zygomatic arch, forming a pseudojoint. The patient was treated with coronoidectomy via an intraoral approach. Histopathological examination revealed features suggestive of OC. Subsequently, the patient was able to open their mouth, and there was no evidence of recurrence or post-operative complications in the 21-month follow-up. A review of the literature revealed only 38 histologically proven cases of coronoid OC in the past 30 years (1989-2018). The incidence of the disease was higher in men compared with that in women (male:female, 2.17:1), and the median age at onset was 28.7 years, with a range of 5-57 years. Gradual limitation of mouth opening and facial asymmetry are the most noticeable symptoms. Water's view and submentovertex projection of the zygomatic arch may be useful in identifying the tumor and its association with the zygoma, while CT and CBCT permit a detailed visualization of the location and density of the tumor. Coronoidectomy is the preferred treatment option, and the prognosis is excellent, with no evidence of recurrence or malignant transformation.
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Affiliation(s)
- Tianjun Lan
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, P.R. China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Xin Liu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, P.R. China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Pei-Sheng Liang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, P.R. China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Qian Tao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, P.R. China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, Guangdong 510055, P.R. China
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8
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Shigeno K, Sasaki Y, Otonari-Yamamoto M, Ohata H, Shibahara T. Evaluating the mandibular condyles of patients with osteoarthritis for bone marrow abnormalities using magnetic resonance T2 mapping. Oral Radiol 2018; 35:272-279. [PMID: 30484208 DOI: 10.1007/s11282-018-0357-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 08/31/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study investigated whether erosion and osteophyte correlates with condyle bone marrow abnormalities (BMA), as detected with quantitative T2 mapping. METHODS Fifty-six joints (in 44 patients) that demonstrated evidence of bony erosion (ER) or osteophytes (OS) related to disc displacement without reduction were studied with MR images. A control group of 50 joints (in 50 patients) was included. The subjects were divided into five groups; noAR (control), noBMA-ER, BMA-ER, noBMA-OS, and BMA-OS. T2 mapping was performed and the regions of interest were placed over the bone marrow at the top of the condyle. The mean T2 values of the bone marrow of the mandibular condyle were calculated for all mapping images. After assessing age-related changes in T2 values of noAR group using Pearson's product-moment, differences in median T2 values of five groups were analyzed using Kruskal-Wallis test, and Steel-Dwass test (p < 0.05). RESULTS There was no significant correlation between age and T2 value in noAR group. The median T2 values of noBMA-ER and BMA-ER groups were significantly higher than those of noAR, noBMA-OS and BMA-OS groups. Those of noBMA-OS and BMA-OS groups were significantly lower than those of noAR, noBMA-ER and BMA-ER groups. There was no significant difference between noBMA and BMA groups. CONCLUSIONS It is suggested that erosion and osteophyte of the condyle may correlate with bone marrow abnormalities. T2 mapping could be show slight marrow changes of the arthritic condyle.
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Affiliation(s)
- Kenichiro Shigeno
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba, 261-8502, Japan.
| | - Yoshinori Sasaki
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-1-14 Misakicho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Mika Otonari-Yamamoto
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-1-14 Misakicho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Hitoshi Ohata
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba, 261-8502, Japan
| | - Takahiko Shibahara
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba, 261-8502, Japan
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A two-year follow-up of surgical and non-surgical treatments in patients with masticatory muscle tendon-aponeurosis hyperplasia. Int J Oral Maxillofac Surg 2017; 47:199-204. [PMID: 28823904 DOI: 10.1016/j.ijom.2017.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/25/2017] [Accepted: 07/13/2017] [Indexed: 11/21/2022]
Abstract
This study re-examined the usefulness of surgery for the management of masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) through a comparison of the outcomes between patients who underwent surgery and those who did not. The duration of follow-up was 2 years. Twenty-eight patients who attended the study hospital and were given a diagnosis of MMTAH were included. Nineteen patients underwent surgery (surgical group) and nine patients were instructed to open their mouths wide once a day and did not undergo surgery (non-surgical group). Maximum mouth opening, impairment of daily activities, satisfaction, and the status of mouth opening training were evaluated after surgery. The mean increase in mouth opening after 2 years was 20.2mm in the surgical group and 2.4mm in the non-surgical group. Adequate mouth opening training led to satisfactory results 2 years postoperative, and sustained mouth opening training for 6 months after surgery was a key factor for obtaining good outcomes. The general condition and personality of individual patients should be evaluated carefully before surgery to estimate whether or not they can endure the pain associated with postoperative mouth opening training. The results of this study suggest that the surgical procedure is useful for the management of MMTAH.
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Sato T, Yoda T. Masticatory muscle tendon-aponeurosis hyperplasia: A new clinical entity of limited mouth opening. JAPANESE DENTAL SCIENCE REVIEW 2017; 52:41-48. [PMID: 28408955 PMCID: PMC5382786 DOI: 10.1016/j.jdsr.2015.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 10/24/2015] [Accepted: 11/11/2015] [Indexed: 11/26/2022] Open
Abstract
Limited mouth opening is a common health problem that interferes with eating, makes examination of the oral cavity difficult, and may increase the mortality rate during emergency intubation. Here we introduce a disease designated as masticatory muscle tendon-aponeurosis hyperplasia, which is a new clinical condition of limited mouth opening. Most oral surgeons and dentists are still unaware of this disease condition, thus increasing the risk of incorrect diagnosis as some other disease, such as temporomandibular joint disorder. We will review the clinical features, epidemiology, pathophysiology, etiology, diagnosis, treatment, and prognosis of this disease and also appraise the literature available on the subject.
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Affiliation(s)
- Tsuyoshi Sato
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Tetsuya Yoda
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
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Yoshida K. Surgical intervention for oromandibular dystonia-related limited mouth opening: Long-term follow-up. J Craniomaxillofac Surg 2017; 45:56-62. [DOI: 10.1016/j.jcms.2016.10.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 09/26/2016] [Accepted: 10/21/2016] [Indexed: 11/26/2022] Open
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Bocchialini G, Castellani A, Negrini S, Rossi A. New Management in Bilateral Masseter Muscle Hypertrophy. Craniomaxillofac Trauma Reconstr 2016; 10:325-328. [PMID: 29109846 DOI: 10.1055/s-0036-1592089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 04/03/2016] [Indexed: 10/20/2022] Open
Abstract
Bilateral masseter muscle hypertrophy is an alteration in shape and thickness of the masseter muscles that can modify the width of the lower face causing aesthetic and functional problems. A 21-year-old man was referred to the Department of Maxillofacial Surgery at the Civil Hospital in Brescia by his dentist for an evaluation of his facial appearance with a square-face type. To reduce the undesirable facial appearance, a surgical intraoral approach was performed; the procedure includes the bilateral dissection of the masseter muscle, partial lipectomy, and the ostectomy of the mandibular angle assisted by a surgical guide built on a stereolithographic model. The patient was satisfied with the functional and aesthetic outcomes of both the profile and the frontal views. There was no evidence of complication at a 1-year follow-up. This new method yields optimal aesthetic results with an enhanced outline of the lower face.
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Affiliation(s)
| | - Andrea Castellani
- Department of Maxillofacial Surgery, Spedali Civili Brescia, Brescia, Italy
| | - Stefano Negrini
- Department of Maxillofacial Surgery, Spedali Civili Brescia, Brescia, Italy
| | - Alessandro Rossi
- Department of Maxillofacial Surgery, Spedali Civili Brescia, Brescia, Italy
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13
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Shigeishi H. Association of temporomandibular disorder with occupational visual display terminal use. Biomed Rep 2016; 5:7-10. [PMID: 27330747 DOI: 10.3892/br.2016.669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 04/14/2016] [Indexed: 11/06/2022] Open
Abstract
Increased visual display terminal (VDT) use has raised the prevalence of VDT-related adverse conditions, such as dry eye disease, and musculoskeletal and psychopathological symptoms, in office workers, including temporomandibular disorder (TMD). Many factors contributing to TMD have been identified, such as parafunctional habit (bruxism and teeth clenching), trauma, mental disorders, lifestyle, poor health, and nutrition, as well as hormonal factors (i.e., estrogen). It is likely that various contributing factors overlap in TMD development in individuals who routinely use a VDT for work. However, the relationship between TMD and VDT use has not been fully elucidated. In this mini-review, findings of recent studies of TMD in relation to occupational VDT use in Japan are discussed, as well as characteristic features and prevention strategies.
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Affiliation(s)
- Hideo Shigeishi
- Department of Oral and Maxillofacial Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima 734-8553, Japan
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14
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Surgical Intervention for Masticatory Muscle Tendon-Aponeurosis Hyperplasia Based on the Diagnosis Using the Four-Dimensional Muscle Model. J Craniofac Surg 2016; 26:1871-6. [PMID: 26352365 PMCID: PMC4568892 DOI: 10.1097/scs.0000000000001932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The surgical target of Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is the masseter or temporal muscle. In our clinic, the 4-dimentional muscle model (4DMM) has been used to decide if we should approach to the masseter or temporal muscle. The aim of this study is validate the clinical usefulness of 4DMM on the basis of the surgical results. METHODS The 4DMM was constructed from the digital data of 3D-CT and 4-dimentional mandibular movements of the patients. It made us to able to visually observe the expansion rate of masticatory muscles at maximum mouth opening comparing to their length at closed mouth position. Fifteen patients were applied the 4DMM before the surgical treatment and 2 healthy volunteers were enrolled as control group. RESULTS The expansion rate of temporal muscle at the maximum mouth opening in the patient group was significantly less than that in the control group (P < 0.05). On the other hand, the masseter muscles of all patients were expanded as same as the control group. Therefore the main cause of limitation of mouth-opening was suggested to be a contracture of the temporal muscle. Consequently, we performed successful bilateral coronoidectomy with no surgical intervention to the masseter muscles in all patients. CONCLUSION The present 4DMM would be valuable modality to decide the target muscle of surgical treatment for patients with MMTAH. In this pathology, contracture of the temporal muscle seems to be main cause of limited mouth opening.
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Kishimoto N, Daigo E, Takada A, Nakamoto A, Momota Y. Use of a bite block to manage the airway of a patient with masticatory muscle tendon-aponeurosis hyperplasia. J Clin Anesth 2016; 29:46-7. [PMID: 26897447 DOI: 10.1016/j.jclinane.2015.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 10/12/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Naotaka Kishimoto
- Department of Anesthesiology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka 540-0008, Japan.
| | - Erina Daigo
- Department of Anesthesiology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka 540-0008, Japan.
| | - Ayaka Takada
- Department of Anesthesiology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka 540-0008, Japan.
| | - Anna Nakamoto
- Department of Anesthesiology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka 540-0008, Japan.
| | - Yoshihiro Momota
- Department of Anesthesiology, Osaka Dental University, 1-5-17, Otemae, Chuo-ku, Osaka 540-0008, Japan.
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Re: Limited mouth opening of unknown cause cured by diagnostic coronoidectomy: a new clinical entity? Br J Oral Maxillofac Surg 2015:53(3):230-4. Br J Oral Maxillofac Surg 2015; 53:476-7. [PMID: 25770017 DOI: 10.1016/j.bjoms.2015.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 02/18/2015] [Indexed: 11/22/2022]
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Sato T, Hayashi N, Enoki Y, Okubo M, Nakaoka C, Nakamoto N, Yoda T. Limited mouth opening with a square mandible configuration: a case of masticatory muscle tendon-aponeurosis hyperplasia. J Surg Case Rep 2015; 2015:rjv020. [PMID: 25770956 PMCID: PMC4359355 DOI: 10.1093/jscr/rjv020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Most clinicians throughout the world are probably unaware of the existence of masticatory muscle tendon-aponeurosis hyperplasia (MMTAH), potentially leading to misdiagnoses such as temporomandibular joint disorder (TMD). Here, we introduce this disease from the viewpoint of education. In February 2013, a 39-year-old woman presented with limited mouth opening. Her facial configuration was characterized by a square mandible. There was no evidence of TMD. Magnetic resonance imaging (MRI) showed bilateral enlargement of the masseter muscles. Additionally, a ‘thick’ aponeurosis of the anterior aspect of the masseter muscle was noted bilaterally. On maximal mouth opening, intraoral palpation along the anterior border of the masseter muscle confirmed a hard cord-like structure, consistent with the findings on MRI. MMTAH was diagnosed. When clinicians notice limited mouth opening on oral examination, they should be knowledgeable about diseases associated with limited mouth opening and a square mandibular configuration, such as MMTAH.
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Affiliation(s)
- Tsuyoshi Sato
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Naoki Hayashi
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Yuichiro Enoki
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Masahiko Okubo
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Chieri Nakaoka
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Norimichi Nakamoto
- Division of Oral and Maxillofacial Biopathological Surgery, Tottori University Faculty of Medicine, Tottori, Japan
| | - Tetsuya Yoda
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
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Nakamoto A, Sato T, Hirosawa N, Nakamoto N, Enoki Y, Chida D, Usui M, Takeda S, Nagai T, Sasaki A, Sakamoto Y, Yoda T. Proteomics-based identification of novel proteins in temporal tendons of patients with masticatory muscle tendon--aponeurosis hyperplasia. Int J Oral Maxillofac Surg 2013; 43:113-9. [PMID: 23870541 DOI: 10.1016/j.ijom.2013.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 06/02/2013] [Accepted: 06/06/2013] [Indexed: 11/26/2022]
Abstract
Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a new disease associated with limited mouth opening that is often misdiagnosed as a temporomandibular disorder; subsequently, patients are mistakenly treated with irreversible operations. Due to the poor presentation and characterization of symptoms, the underlying pathological conditions remain unclear. We have previously conducted a proteomic analysis of tendons derived from one MMTAH subject and one facial deformity subject using two-dimensional fluorescence difference gel electrophoresis and liquid chromatography coupled with tandem mass spectrometry. However, the results were obtained for only one subject. The aim of the present study was to confirm the expression of specific molecules in tendon tissues from multiple subjects with MMTAH by applying two-dimensional polyacrylamide gel electrophoresis with matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Of the 19 proteins identified in tendons from both MMTAH and facial deformity patients, fibrinogen fragment D and beta-crystallin A4 were up-regulated, whereas myosin light chain 4 was down-regulated in MMTAH. We also found fibrinogen to be expressed robustly in tendon tissues of MMTAH patients. Our data provide the possibility that the distinctive expression of these novel proteins is associated with the pathology of MMTAH.
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Affiliation(s)
- A Nakamoto
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - T Sato
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan.
| | - N Hirosawa
- Department of Biomedical Research Center, Division of Analytical Science, Saitama Medical University, Saitama, Japan
| | - N Nakamoto
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - Y Enoki
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - D Chida
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
| | - M Usui
- Department of Periodontology, Kyushu Dental College, Kitakyushu City, Fukuoka, Japan
| | - S Takeda
- Division of Endocrinology, Metabolism and Nephrology, Keio University, Tokyo, Japan
| | - T Nagai
- Department of Pathology, Saitama Medical University, Saitama, Japan
| | - A Sasaki
- Department of Pathology, Saitama Medical University, Saitama, Japan
| | - Y Sakamoto
- Department of Biomedical Research Center, Division of Analytical Science, Saitama Medical University, Saitama, Japan
| | - T Yoda
- Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
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Yoshida H, Oshiro N, Fukuda A, Gamoh S, Shimizutani K, Morita S. A case of reformed coronoid process and mandibular angle after coronoidectomy and anglectomy for masticatory muscle tendon-aponeurosis hyperplasia. Oral Radiol 2013. [DOI: 10.1007/s11282-013-0145-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Sato T, Hori N, Nakamoto N, Akita M, Yoda T. Masticatory muscle tendon‐aponeurosis hyperplasia exhibits heterotopic calcification in tendons. Oral Dis 2013; 20:404-8. [DOI: 10.1111/odi.12140] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 05/06/2013] [Accepted: 05/15/2013] [Indexed: 12/27/2022]
Affiliation(s)
- T Sato
- Department of Oral and Maxillofacial Surgery Saitama Medical University Moroyama‐machi, Iruma‐gun Japan
| | - N Hori
- Department of Oral and Maxillofacial Surgery Saitama Medical University Moroyama‐machi, Iruma‐gun Japan
| | - N Nakamoto
- Department of Oral and Maxillofacial Surgery Saitama Medical University Moroyama‐machi, Iruma‐gun Japan
| | - M Akita
- Division of Morphological Science Saitama Medical University Moroyama‐machi, Iruma‐gun Japan
| | - T Yoda
- Department of Oral and Maxillofacial Surgery Saitama Medical University Moroyama‐machi, Iruma‐gun Japan
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Sato T, Nakamoto A, Hori N, Enoki Y, Fukushima Y, Nakamoto N, Sakata Y, Yamanaka H, Chida D, Abe T, Yoda T. Proteomic analysis of masticatory muscle tendon–aponeurosis hyperplasia: A preliminary study using a 2D-DIGE system. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2012. [DOI: 10.1016/j.ajoms.2012.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Yamamoto I, Inoue S, Kawaguchi M, Kawakami T, Kirita T, Furuya H. Anesthetic considerations for masticatory muscle tendon-aponeurosis hyperplasia: a report of 24 cases. Anesth Prog 2012; 59:87-9. [PMID: 22822997 DOI: 10.2344/11-27.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a new disease entity characterized by limited mouth opening due to contracture of the masticatory muscles, resulting from hyperplasia of tendons and aponeuroses. In this case series, we report what methods of airway establishment were conclusively chosen after rapid induction of anesthesia. We had 24 consecutive patients with MMTAH who underwent surgical release of its contracture under general anesthesia. Rapid induction of anesthesia with propofol and rocuronium was chosen for all the cases. In 7 cases, intubation using the Macintosh laryngoscopy was attempted; however, 2 of those cases failed to be intubated on the first attempt. Finally, intubation using the McCoy laryngoscopy or fiber-optic intubation was alternatively used in these 2 cases. In 7 cases, the Trachlight was used. In the remaining 10 cases, fiber-optic intubation was used. Limited mouth opening in patients with MMTAH did not improve with muscular relaxation. "Square mandible" has been reported to be one of the clinical features in this disease; however, half of these 24 patients lacked this characteristic, which might affect a definitive diagnosis of this disease for anesthesiologists. An airway problem in patients with MMTAH should not be underestimated, which means that other intubation methods rather than direct laryngoscopy had better be considered.
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Affiliation(s)
- Ikumi Yamamoto
- Department of Anesthesiology, Nara Medical University, Kashihara, Japan
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Yamada H, Hamada Y, Fujihara H, Fukami K, Mishima K, Nakaoka K, Kumagai K, Imamura E. Solitary fibrous tumor of the buccal space resected in combination with coronoidectomy. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:e9-14. [DOI: 10.1016/j.tripleo.2011.07.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 07/22/2011] [Accepted: 07/29/2011] [Indexed: 11/25/2022]
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Abstract
Masseter muscle hypertrophy is characterized by unilateral or bilateral enlargement of the masseter muscles affecting both females and males after puberty. Limitations on mouth opening, swollen cheek, and also tension in the region of the hypertrophied muscle are symptoms reported. Also, masseter hypertrophy can cause aesthetic and functional problems. A 40-year old woman was referred to our clinic with the chief complaint of facial appearance with square-face type. To eliminate undesirable facial appearance, surgical intraoral approach compromising reduction of deep masseter muscle with monocortical and bicortical ostectomy of the angle of the mandible was performed. The patient was satisfied with both functional outcomes and aesthetic outcomes on both facial profile and frontal view. No complication was seen intraoperatively and postoperatively after a 12-month follow-up period. This treatment modality would be suggested to gain optimal aesthetic results especially in a square face from the lateral profile.
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Morimoto Y, Sugimura M, Hanamoto H, Niwa H. Limited mouth opening following induction of anesthesia in two patients with masticatory muscle tendon-aponeurosis hyperplasia. J Clin Anesth 2011; 23:598-600. [PMID: 22050818 DOI: 10.1016/j.jclinane.2010.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 10/28/2010] [Accepted: 12/09/2010] [Indexed: 11/30/2022]
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26
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Inoue S, Yamamoto I, Ikeda S, Kawaguchi M, Kawakami T, Kirita T, Furuya H. Possible difficult laryngoscopy caused by masticatory muscle tendon-aponeurosis hyperplasia: we anesthesiologists should be aware of this disease. J Anesth 2010; 24:930-1. [PMID: 20721609 DOI: 10.1007/s00540-010-1010-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 07/28/2010] [Indexed: 11/26/2022]
Abstract
Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a new disease entity characterized by limited mouth opening due to contracture of the masticatory muscles resulting from hyperplasia of tendons and aponeuroses. The other clinical feature is that the face of the patient with this disease displays a square mandible configuration. Muscle relaxants provide no relief for the limited mouth-opening ability. Anesthesiologists need to suspect difficult airway when patients have limited mouth opening with square mandible configuration. MMTAH can therefore be a possible cause of difficult intubation.
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Affiliation(s)
- Satoki Inoue
- Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara 634-8522, Japan.
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Abstract
Masseter hypertrophy is an uncommon condition that can cause aesthetic and functional problems. Various treatment options were suggested by authors. We used surgical intraoral approaches in 5 patients, which consist of masseter muscle reduction and monocortical ostectomy in the angle of the mandible. Results showed good aesthetic results without any complication. We suggest the use of surgical treatment to gain optimal aesthetic results especially in a square face.
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