Myositis ossificans of the left medial pterygoid muscle: case report and review of the literature of myositis ossificans of masticatory muscles

Patient-specific PEEK implant for treatment of temporal myositis ossificans (five years follow-up): A case report

Myositis ossificans of the temporalis muscle results in a cosmetic problem both before and after treatment because of the preoperative swelling and the postoperative defect respectively. The authors hypothesized that a patient-specific Polyether-ether ketone implant can be appropriate for immediate obliteration and reconstruction of such defect benefiting from the accuracy of CAD/CAM technology and computer-guided maxillofacial surgery. A Forty-year-old male patient with myositis ossificans affecting the left temporalis muscle was treated with a computer-guided surgical approach, a patient-specific implant was fabricated to obliterate the defect and avoid temporal hollowing using PEEK material. The functional and cosmetic results were satisfactory both immediately and at the 5-year follow-up, except that the skin over the implant was noticed to be stretched after 5 years. Hence, it can be concluded that virtual surgical planning and PEEK patient-specific implants are reliable in the immediate reconstruction of post-surgical temporal hollowing.

Traumatic Myositis Ossificans of Temporalis Muscle: Systematic Review, Meta-Analysis and Case Reports

Introduction

Traumatic myositis ossificans is rare pathology affecting muscles/soft tissue. Its involvement in temporalis muscle is rarely reported in literature. The aetiopathogenesis is unknown, the diagnosis is based on clinco-radiological findings. Surgical management and follow-up are paramount.

Materials and Methods

A database search was done using Science Direct and PubMed search engines along with other published and unpublished literature. The final publications were tabulated using a custom made Performa. The available publications were subjected to appropriate statistical analysis. The data were recorded on excel spreadsheet (Microsoft Inc), and review was made using Review Manager (Rev Man) software for meta-analysis.

Results

A total of 21 articles were considered for systemic review and meta-analysis. Forest plotting for demographics included the gender predilection/age of involvement. The data segregation was done with "temporalis involved" group and "other than temporalis involved" group. The study was free of homogeneity ( τ 2 = 0.26 I 2 = 5%) for gender and age. The overall analysis revealed that Temporalis muscle although rare to be affected shows greater propensity for involvement. This is supported by a lesser degree of heterogeneity ( τ 2 = 0.000) with a I 2 value of (The test showed a higher degree of significance for overall effect of muscle involvement (Z = 2.33, p = 0.02) (< 25%). The test showed a higher degree of significance for overall effect of muscle involvement (Z = 2.33, p = 0.02) (< α = 0.05).Case reports.Two male cases with similar age predilection, reported after sustaining trauma. Both the cases presented with limited mouth opening and ultrasound was done for the first time to arrive at clinic-radiological diagnosis. The management was conservative with temporalis myotomy and coronidectomy.

Conclusion

Traumatic myositis ossificans presents as a rare disorder that poses a dilemma to the treating surgeon. The present article makes an attempt to critically analyse the pathology that is scantly reported in the literature.

Management of bilateral pterygoid myositis ossificans-like lesion in dogs

Myositis ossificans (MO) and myositis ossificans-like lesions have been rarely described within the veterinary literature, and are even less common in the maxillofacial region. When MO affects the muscles of mastication, it can result in complete or partial inability to open the mouth. As with other conditions resulting in decreased or restricted mandibular range of motion, severe and potentially fatal sequelae such as difficulty with prehension, swallowing, and air exchange are possible. Diagnostic imaging is essential in achieving an accurate diagnosis and in formulating an appropriate treatment plan. In this “method” manuscript, we provide a detailed description of our approach to diagnosis and surgical management of MO-like lesions of the pterygoid muscles and describe our experience with two young French bulldogs.

Non-traumatic myositis ossificans of the Right masseter muscle: a case report and review of the literature

Myositis ossificans (MO) is a rare disease in which ossification develops in the muscle or soft tissue. MO traumatica is recognized by ossification of the soft tissues after acute or repetitive trauma, burns, or surgical procedures. It usually involves the extremity muscles. In the head and neck region, the masseter is most commonly involved in MO traumatica. Surgical resection of the ossified tissue has been the most commonly used treatment for this disorder, with a high postoperative recurrence rate. We report a case of non-traumatic MO of the Masseter muscle with different size round calcifications and to review the literature reported data about MO traumatica involving the masseter muscle.

Myositis ossificans of the masticatory muscle monitored over three generations: A case report and review of the literature

Myositis ossificans (MO) is a rare disease and its major feature is the formation of heterotropic bone involving muscle or any other type of soft tissue (tendons, ligament, fascia and connective tissue). In the present study, a case report of a patient diagnosed with MO is presented. The diagnosis was established by evaluation of the medical history of the patient and the patient's family, as well as clinical data, radiology and post-operative pathology. The patient underwent excision surgery of the calcified lesion. In addition, genomic DNA was examined from blood samples of the patient and the patient's father with their consent. A mutation in the non-coding region was detected but any direct causative effect remains elusive. The present case report provided significant information with regard to the incidence of MO in four members of the same family assessed over three generations. The disease exhibited a unique localization in the maxillofacial region.

Myositis Ossificans Traumatica of the Temporal Muscle: a Case Report and Literature Review Emphasizing Radiographic Features on Computed Tomography and Magnetic Resonance Imaging

Objectives

Heterotopic bone formation within a muscle is designated as ‘myositis ossificans’, and it is associated with multiple aetiologies, such as trauma, genetic predisposition, post-infection, or undetermined causes. When the disease develops as a result of a trauma, the myositis ossificans is classified as ‘myositis ossificans traumatica’. In this case report, a case of myositis ossificans traumatica is described, emphasizing its imaging features. Additionally, a literature review of the imaging features of myositis ossificans is discussed.

Material and Methods

A 60-year old male patient presented with restricted mouth opening and pain during mastication. Multislice computed tomography and magnetic resonance imaging examinations were conducted. Case reports in the literature of myositis ossificans were searched databases from August 1984 until April 2019 using the keyword ‘masticatory muscles’ combined with ‘myositis’; ‘inflammatory myositis’; infectious myositis’; ‘inflammatory muscle diseases’; ‘focal myositis’ and ‘proliferative myositis’. Data was summarised and evaluated according to a critical appraisal checklist for case reports.

Results

Multislice computed tomography demonstrated an ectopic hyperdense area arising from the coronoid bone and within the temporal muscle. Magnetic resonance imaging demonstrated the same area with a hypointense signal. In the literature review, 53 myositis ossificans cases were identified, and 12 cases affecting the temporal muscle were found.

Conclusions

The main imaging feature of myositis ossificans is the presence of a radiopaque, hyperdense or hypointense mass in the affected muscle, which is seen on multislice computed tomography and magnetic resonance imaging, respectively. The final diagnosis is through histopathological examination, although imaging can suggest the most likely diagnosis.

Incidental Findings in TMJ Imaging

For years, the conventional imaging modalities are generally used in dental practice routine. They provide precious information about dentomaxillofacial region; they also have some limitations such as superimpositions, magnifications, distortions, and low-image quality. Because of these limitations, some pathologies, calcifications, and anatomical variations may be missed. Any findings on a radiographic image which are not related to the research areas of interest could be a description of “incidental findings.” Calcifications are one of these incidental findings. They are asymptomatic and also common in TMJ images. Although most of the calcifications require no treatment, correct identification will reduce further diagnostic assessments. Incidental findings on TMJ images were rare, while examining images for temporomandibular disorders and associated issues, it is important not only to examine the TMJ structures but also to look at the nearby anatomical features to check for evidence of incidental findings pathologies that may have mimicked signs and symptoms of TMJ disorders.

Myositis ossificans traumatica of the masticatory muscles: etiology, diagnosis and treatment

BACKGROUND

Myositis ossificans describes a heterotopic bone formation within a muscle. Thereby myositis ossificans is classified in two different groups: myositis ossificans progressiva (MOP) which describes a genetic autosomal dominant rare disease and myositis ossificans traumatica (MOT). The exact pathogenesis of MOT is unclear. The aim of this article was to analyse and interpret the existing literature reporting MOT of masticatory muscles and compare the results with our own clinical experience with MOT. Risk-factors, etiology, clinical features, diagnostic imaging, as well as different treatment options were evaluated and recommendations for the prevention, diagnosis, and therapy of MOT of the masticatory muscles were given.

METHODS

Following the PRISMA-Guidelines, a systematic search within the PubMed/Medline database with a view to record literature of MOT of the masticatory muscles was performed. Furthermore, the database of our own clinic was screened for cases of MOT.

RESULTS

In total, 63 cases of MOT of the masticatory muscles which were reported in English-based literature were included in this study. Overall, 25 female and 37 male patients could be analysed whereas one patient's gender was unknown. Complication of wisdom-tooth infection (n = 3) as well as the results of dental procedures like dental extraction (n = 7), mandibular nerve block (n = 4), periodontitis therapy (n = 1) were reported as MOT cases. From the 15 reported cases that appeared after dental treatment like extraction or local anesthesia the medial pterygoid (n = 10) was the most affected muscle. Hereof, females were more affected (n = 9) than males (n = 6). The most reported clinical symptom of MOT was trismus (n = 54), followed by swelling (n = 17) and pain (n = 13). One clinical case provided by the authors was detected.

CONCLUSIONS

Dental procedures, such as local anesthesia or extractions, may cause MOT of the masticatory musculature. Demographical analyses demonstrate that females have a higher risk of developing MOT with respect to dental treatment. The most important treatment option is surgical excision. Subsequent physical therapy can have beneficial effects. Nevertheless, a benefit of interpositional materials and drugs as therapy of MOT of the masticatory muscles has not yet been proven. Myositis ossificans progressiva has to be excluded.

Myositis ossificans of the masseter muscle: A rare location. Report of a case and review of literature

BACKGROUND

Myositis Ossificans is a rare heterotopic bone formation within a muscle being the masticatory muscles exceptionally involved. In most cases there is a previous trauma, bearing in mind that there may be many other etiologies. CT scan and panoramic radiographs along with histological findings are essential diagnostic aids.

CASE DESCIPTION

We report a rare case of MO of masseter muscle in 49 years-old woman after repetitive wisdom tooth infection with the discussion of clinical, radiological and histological features.

CLINICAL IMPLICATIONS

MO is a rare disease of masticatory muscles being the masseter the most frequently affected. Wide surgical excision with free margins is the treatment of choice although close postoperative monitoring it's essential to avoid relapses.

KEY WORDS

Myositis ossificans, myositis ossificans traumatica, masticatory muscles, masseter muscle, trauma.

Myositis ossificans traumatica of the medial pterygoid muscle following a third molar extraction

Myositis ossificans (MO) is a rare disease involving heterotopic ossification in the muscle or soft tissue. Myositis ossificans traumatica (MOT) disease presents as a calcification within the injured muscle, resulting from a single or repetitive injury. There are few reports of MOT in the masticatory muscles. The case of a patient with MOT in the medial pterygoid muscle caused by a complication related to the extraction of an erupted upper third molar is reported. The major symptom was severe trismus. Despite surgical treatment, the disease relapsed. MOT can lead to serious consequences for the patient. Its aetiopathogenesis needs to be better understood, so that the most appropriate treatment is established and relapses are minimized. This will improve the quality of life of these patients.