Masticatory muscle tendon-aponeurosis hyperplasia  accompanied by limited mouth opening

Yoda, Tetsuya

doi:10.5125/jkaoms.2019.45.4.174

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…A condition similar to MMH is masticatory muscle tendon-aponeurosis hyperplasia, which presents itself with a hard cord-like structure along the overhang of the anterior border of the masseter muscle on intraoral palpation along with restricted mouth opening. 28 The other features are similar to hypertrophy of the muscle. The standard therapy considered for the management is bilateral coronoidectomy with anterior partial aponeurectomy of the masseter muscle.…”

Section: Discussionmentioning

confidence: 83%

Management of Masseter Muscle Hypertrophy and Role of Adjunctive Surgical Procedures

Anehosur

Mehra

Kumar

2020

Craniomaxillofacial Trauma & Reconstruction Open

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Aims and Objectives: The aim of this case series is to retrospectively analyze cases of masseter muscle hypertrophy and the surgical procedures carried out for their treatment in SDM craniofacial unit, Dharwad. The main objectives taken into account are the adjunctive procedures such as genioplasty and coronoidectomy, which help improve the esthetics and mouth opening of the patients postoperatively. Materials and Methods: This retrospective case series was conducted in the Department of Oral and Maxillofacial Surgery, SDM craniofacial unit, Dharwad, from 2010 to 2015. A total of 5 cases were operated on during this period. Orthopantomograms, computed tomography scans of the head and neck region, and lateral cephalograms of each patient were taken into account. Data were collected to study the treatment protocols and the adjunctive procedures, which helped improve the results of the surgery. Results: Of the 5 patients operated in the last 5 years, surgical debulking of the masseter muscle was the optimal treatment followed with genioplasty, which provided improved esthetics from the square-shaped jaw appearance. Coronoidectomy was helpful in increasing mouth opening in patients with trismus. Conclusion: The case series was not only carried out to enunciate causes of masseter muscle hypertrophy and its complications but also to discuss optimal treatment protocols along with adjunctive procedures to enhance the postoperative results and patient satisfaction.

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Section: Discussionmentioning

confidence: 83%

Management of Masseter Muscle Hypertrophy and Role of Adjunctive Surgical Procedures

Anehosur

Mehra

Kumar

2020

Craniomaxillofacial Trauma & Reconstruction Open

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“…Coronoidectomy is performed to remove the tendon arising from the posterior and superior aspects of the coronoid process. Although mandibular anglectomy is also known according to Yoda et al, it is unnecessary to improve the limited mouth opening [2]. However, mandibular anglectomy can still be performed for aesthetic reasons.…”

Section: Discussionmentioning

confidence: 99%

“…Restricted mouth opening can be due to temporomandibular disorders, fracture of the condylar process, neurological disorders, rheumatoid arthritis, inflammation, tumours or hyperplasia of the coronoid process. Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a different clinical complaint associated with partial mouth opening [2]. Prominent mandibular angle in Orientals has also been attributed to lateral flaring as well as the development of the posterior part of the angle of the mandible instead of Masseter muscle hypertrophy [3].…”

Section: Introductionmentioning

confidence: 99%

Masticatory muscle tendon-aponeurosis hyperplasia: clinical presentation and management

Qattan

Hashmi

Rashdi

2022

J Oral Med Oral Surg

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Introduction: Masseter muscle enlargement accompanied by hypertrophy of Mandibular angle can significantly affect the appearance and quality of life. The treatment methods can be varied, and, in the present study, osteotomy of Mandibular angle and treatment of Masseter muscle with Botulinum toxin was carried out. Observation: In this case study, a 19-year-old female patient was admitted with inadequate mouth opening for three years. Clinical examination and Cone-Beam Computed Tomography scan revealed bilateral well-developed Masseter muscles and hypertrophy of mandibular angle on both sides. Osteotomy of mandibular angle was performed. Additionally, 25 units of Botulinum toxin were administered. This improved the aesthetic appearance and increased the mouth opening from 21 mm to 38 mm in one year after surgery. Conclusion: Oral and maxillofacial surgeons should consider Masticatory muscle tendon-aponeurosis hyperplasia as a differential diagnosis when the patient's chief complaint is inadequate mouth-opening with a square mandible. Osteotomy of mandibular angle in conjunction with, Botulinum toxin is efficient in cases of Masseter muscle hypertrophy and an enlargement of the Mandibular angle.

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“…Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a relatively newly identified clinical condition that manifests as trismus with a square-shaped mandible [ 2 , 3 ]. The pathology of MMTAH is recognized as hyperplasia of the masseter muscle aponeurosis and temporalis muscle tendon [ 4 ]. However, the etiology and clinical aspects of this disease remain unknown.…”

Section: Introductionmentioning

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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Masticatory muscle tendon-aponeurosis hyperplasia accompanied by limited mouth opening

Cited by 5 publications

References 20 publications

Management of Masseter Muscle Hypertrophy and Role of Adjunctive Surgical Procedures

Management of Masseter Muscle Hypertrophy and Role of Adjunctive Surgical Procedures

Masticatory muscle tendon-aponeurosis hyperplasia: clinical presentation and management

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

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