A case of reformed coronoid process and mandibular angle after coronoidectomy and anglectomy for masticatory muscle tendon-aponeurosis hyperplasia

Yoshida, Hiroaki; Oshiro, Nobuyoshi; Fukuda, Aoi; Gamoh, Shoko; Shimizutani, Kimishige; Morita, Shosuke

doi:10.1007/s11282-013-0145-1

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…Coronoidectomy should be performed to remove the tendon arising from the posterior and superior aspects of the coronoid process. Although mandibular anglectomy is also reported2324, we think that it is unnecessary for the improvement of the limited mouth opening. However, mandibular anglectomy can still be performed for aesthetic reasons.…”

Section: Treatmentmentioning

confidence: 86%

Masticatory muscle tendon-aponeurosis hyperplasia accompanied by limited mouth opening

Yoda

2019

JKAOMS

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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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Section: Treatmentmentioning

confidence: 86%

Masticatory muscle tendon-aponeurosis hyperplasia accompanied by limited mouth opening

Yoda

2019

JKAOMS

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“…However, mandibular anglectomy was performed in only three cases, according to these reports. This seems to be the case because it is now chosen for esthetic reasons, particularly for square mandibles [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

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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“…Mandibular anglectomy is unnecessary, but can still be performed for esthetic reasons. Moroi et al [25] and Yoshida et al [26] also reported that they sometimes carry out mandibular anglectomy for a square mandible. Yoshida et al [26] suggested that mandibular anglectomy induces disuse atrophy of the masseter and medial pterygoid muscles.…”

Section: Treatmentmentioning

confidence: 99%

“…Thus, most of these cases required another surgical operation [27], [28], [29]. Yoshida et al [26] also reported a case of reformed coronoid process and mandibular angle after coronoidectomy and anglectomy for masticatory muscle tendon-aponeurosis hyperplasia. Furthermore, they suggested that postoperative mouth opening training is an important prognostic factor for preventing the limitation of mouth opening in masticatory muscle tendon aponeurosis hyperplasia.…”

Section: Treatmentmentioning

confidence: 99%

Masticatory muscle tendon-aponeurosis hyperplasia: A new clinical entity of limited mouth opening

Sato

Yoda

2016

Japanese Dental Science Review

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SummaryLimited 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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A case of reformed coronoid process and mandibular angle after coronoidectomy and anglectomy for masticatory muscle tendon-aponeurosis hyperplasia

Cited by 6 publications

References 10 publications

Masticatory muscle tendon-aponeurosis hyperplasia accompanied by limited mouth opening

Masticatory muscle tendon-aponeurosis hyperplasia accompanied by limited mouth opening

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

Masticatory muscle tendon-aponeurosis hyperplasia: A new clinical entity of limited mouth opening

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