Benign masseter muscle hypertrophy is an uncommon clinical phenomenon of uncertain aetiology which is characterised by a soft swelling near the angle of the mandible. Concurrent occurrence of masseter muscle hypertrophy along with medial pterygoid muscle. Getting botox masseter hypertrophy treatment has helped a number of people around the world enjoy a. The masseter is a facial muscle and lies in front of the ear and connects the top portion of the upper jaw zygomatic arch and maxilla to the lower portion of. Radio frequency appears to induce coagulation tissue necrosis of the masseter muscle. Feb 25, 2019 idiopathic masseter muscle hypertrophy is a rare condition, characterized by unilateral or bilateral enlargement of this muscle, sometimes associated to mandibular angle exostosis. The masseter muscle is involved in mastication, elevation and protrusion of the mandible, functions which develop it into a powerful muscle. Crucial for relieving headaches, tmj, clenching, and bruxism a few days ago a user on rbodyweightfitness asked for help in regards to them clenching their jaw during exercise because it was causing a lot of tension to the rest of their skull. Prolonging the duration of masseter muscle reduction by. In other cases, larger masseter muscles may have a genetic cause. Masseter muscle hypertrophy is a rare condition of unknown cause which is important in the differential diagnosis of head and neck masses, located in the cheek. Dec 18, 2017 masseter hypertrophy is a common, prominent feature in many asian patients, and correction procedures are often requested for esthetic reasons.
Its etiology is unknown, and there is a possible relation with unilateral masticatory activity, dental malocclusion, temporomandibular joint dysfunction, bruxism, or emotional alterations. Idiopathic hypertrophy of the masseter muscle is a rare disorder of unknown cause. Complications of botulinum toxin injection for masseter. Masseter hypertrophy mh is one of the uncommon conditions that. Masseter muscle hypertrophy is a relatively rare and benign enlargement of unilateral or bilateral masseter muscles. Several treatment options reported for masseter hypertrophy, which range from simple pharmacotherapy to more invasive surgical reduction.
Contraction of the muscle raises the mandible, and it is particularly used in chewing food. The outcome was noted clinically standardized photography and ultrasonographically. Thus we should refer to it as hyperplasia rather than hypertrophy of the masseteric muscle. Masseter and medial pterygoid muscle hypertrophy bmj. Botox injections to the masseter are commonly used to treat bruxism, jaw pain, or headache. New management in bilateral masseter muscle hypertrophy.
Masseter muscle hypertrophy is characterized by unilateral or bilateral enlargement of the masseter muscles affecting both males and females after puberty. Pdf masseter muscle hypertrophy is characterized by unilateral or bilateral enlargement of the masseter muscles affecting both males and. There recently came to our attention a patient with facial asymmetry due to hypertrophy of the masseter muscles. Commonly seen in anxious individuals with bruxism and in chronic gum chewing.
Botulinum toxin type a for masseter hypertrophy cochrane. The superficial part of the muscle that lies over its deep part originates from the maxillary process of the zygomatic bone. Until now, few reports have discussed how to prolong the duration of its effectiveness. Several treatment options reported for masseter hypertrophy are present, which range from simple pharmacotherapy to more. However, in some individuals the swelling can be associated with pain or may be so large that it causes facial disfigurement. Masseter muscle hypertrophy treated with botulinum toxin e649. Botulinum toxin type a is a powerful neurotoxin which is produced by the anaerobic organism clostridium botulinum and when injected into a muscle causes interference with the neurotransmitter mechanism. Referred pain and tenderness from masseter trps may cause tooth hypersensitivity to any or all stimuli. Pain into the upper and lower molars from the masseter muscle can be the source of ongoing tooth pain which the patient and dentist find difficult to treat.
Since the 1880s, medical options such as sedatives, muscle relaxants, and occlusal splints have been used to treat benign masseteric hypertrophy. Possible reactions after treatment are mild and include transient swelling at the injection site, low grade fever, and soreness. Oct 05, 20 the aim of the present study was to evaluate the efficacy of and patient satisfaction with the treatment of masseter hypertrophy for lower facial remodeling using 90u of abobotulinum toxin a given on each side on the face within the safe area determined by the literature, in a sample of 10 brazilian patients followed up for 6 months. Even if the hypertrophy is bilateral, asymmetry of the face may still occur due to unequal. Some authors associate it with the habit of chewing gum, temporomandibular joint disorder, congenital and functional hypertrophies, and emotional disorders stress and nervousness. The etiology of mh includes several factors, and various treatment methods are mentioned in the literature. Botox masseter hypertrophy treatment in mumbai, india. Masseter muscle hypertrophy may occur over long periods of time because of teeth grinding bruxism. Jul 10, 2012 masseter muscle hypertrophy is a rare condition of idiopathic cause. Yes, there are reports of radiofrequency used to to reduce hypertrophied masseter muscles. Temporalis muscle hypertrophy tmh is a rare entity of masticatory muscle hypertrophy. Masseter hypertrophy and tmj in memphis and germantown. It has both implications for wellbeing and for aesthetic beauty.
Varying degrees of success have been reported for some of the treatment options for masseter. Hypertrophy of the masseter or temporalis muscles or both. Idiopathic masseter muscle hypertrophy immh was first described by legg in 1880, reporting on the case. Combination of medical and surgical treatments for masseter. Masseter muscle hypertrophy is a benign condition that can cause facial asymmetry and aesthetic concern in young individuals. Cmmh is a benign increase in size of the masseter muscle and can be unilateral or bilateral 2 secondary to muscle hypertrophy. Bilateral masseter and internal pterygoid muscle hypertrophy. It clinically presents as an enlargement of one or both masseter muscles. Pdf botulinum toxin type a in the management of masseter. Masseter muscle hypertrophy case report article pdf available in brazilian dental journal 174.
Masseter muscle hypertrophy jama dermatology jama network. Idiopathic masseter muscle hypertrophy immh was first described by legg in 1880, reporting on the case of a 10yearold girl with concurrent idiopathic temporalis muscle hypertrophy. Unilateral masseter hypertrophy is more commonly seen in parotid infections,tumors, myeioma or mandibular tumors takamasa, 2000. It is most commonly seen in late adolescence and early adulthood. Masseter, from greek masasthai, to chew, prominent muscle of the jaw. Treatment of masseteric hypertrophy with botulinum toxin. Objective this study evaluated that purposely adjusting the masticatory movements is possible of postponing the masseter muscle rehypertrophy methods ninetyeight patients were randomly and. Ultrasound investigation in congenital masseter hypertrophy. The hyperfunction leads to the hypertrophy of the muscle. Furthermore, the advantage to assessing patients weekly at initial injection is that muscular weakness and atrophy can be serially assessed prior to reinjection.
Pdf masseter muscle hypertrophy case report researchgate. The masseter muscle is one of the four principal muscles of mastication chewing and is essential for adequate mastication. The masseter muscle is essential for adequate mastication and is located laterally to the mandibular ramus, and thus plays an important role in facial. This chapter outlines and organizes the various possible complications of such a procedure and discusses their incidence rates, etiological explanations, and prevention methods. Sometimes, botox can cause atrophy of the muscle as a side effect. Masseter trigger point diagram, pain patterns and related medical symptoms. Tmh is most commonly bilateral and usually associated with other types of masticatory muscles hypertrophy 1. The masseter muscle brings the jaw together for chewing and relative to its size is the strongest muscle in the body. Bilateral temporalis and masseter muscles are hypertrophic resulting in pseudomasses. Twenty patients presenting masseter hypertrophy and that had undergone surgical treatment were studied. Botox or placebo will be administered intramuscularly to the bilateral masseter muscles 6 total injections, 3 injections masseter. Masseter muscle hypertrophy is an asymptomatic, benign enlargement of one or both masseter muscles.
Management of masseter muscle hypertrophy and role of. It is one of the masticatory muscles, a group of muscles which also includes the temporal muscle, lateral pterygoid muscle and medial pterygoid muscle. The masseters act to raise the lower jaw and compress the teeth together in the act of chewing. Masseter and medial pterygoid muscle hypertrophy bmj case. Excision of the internal layer of the masseter muscle and reduction of. Pdf idiopathic hypertrophy of the masseter muscle is a rare disorder of unknown cause. The treatment of masseter hypertrophy with botulinum toxin. Masseter muscle is a paired, strong, thick and rectangular muscle that is originating from the zygomatic arch and extends down to the mandibular angle. In conclusion, this pilot study revealed that botox injection in patients with masseter hypertrophy offers a. The swelling may on occasion be associated with facial pain and can be prominent enough to be considered cosmetically disfiguring. Idiopathic masseter muscle hypertrophy is a rare condition, characterized by unilateral or bilateral enlargement of this muscle, sometimes associated to mandibular angle exostosis.
The masseter muscle can become enlarged in patients who habitually clench or grind with bruxism their teeth and even in those who constantly chew gum. Pdf benign masseter muscle hypertrophy researchgate. Idiopathic masticatory muscle hypertrophy is a relatively rare disorder which usually manifests in late adolescence or early adulthood. Nov 01, 2016 masseter hypertrophy is a rare condition and the etiology in the majority of the cases is unclear. Botulinum neurotoxin bont injection for the correction of masseter muscle hypertrophy is an offlabel but increasingly popular procedure, especially in asians where masseter hypertrophy is a common facial feature. The masseter muscle can contribute to many areas of pain in the face and head. Botulinum toxin type a in the management of masseter muscle hypertrophy. The masseter muscle is essential for adequate mastication and is located laterally to the mandibular ramus, and thus plays an important role in facial esthetics. Combination of medical and surgical treatments for. Rare disease masseter and medial pterygoid muscle hypertrophy. There are several theories about the etiology of masseter muscle. Surgical technique botulinum toxin for masseter reduction in.
This study is a multicenter, randomized, doubleblind, placebocontrolled, up to 2treatment, dose escalation study. It is a relatively rare condition, with around cases reported in the literature since the first described. Masseter muscle hypertrophy treated with botulinum toxin orofacial dystonies, sialorrhea, freys syndrome, muscle hypertrophies, etc 69. However, a thorough search failed to disclose any reports concerning this disease entity in dermatologic. The treatment of masseter hypertrophy with botulinum toxin type a. This asymptomatic persistent muscle enlargement may be initiated by bruxism, clenching, or heavy gum chewing 3,6. Three recent cases presented briefly serve to illustrate this condition.
There appears to be little awareness among pediatricians of masseter or temporalis muscle hypertrophy which may mimic other conditions, particularly parotitis. Masseter hypertrophy is a common, prominent feature in many asian patients, and correction procedures are often requested for esthetic reasons. The surgical solution for masseter hypertrophy is to cut out a portion of the masseter muscle with or without reduction of any thickened underlying bone. Lower facial remodeling with botulinum toxin type a for the. Masseter hypertrophy mh is one of the uncommon conditions that swelling can be seen in the angular mandibular region of the face.
Unilateral occurrence and isolated temporalis masseter enlargement has also been reported but is rare. Hypertrophy of masseteric muscle 349 discussion masseter muscle hypertrophy is an asymptomatic, benign enlargement of one or both masseter muscles. Temporalis and masseter hypertrophy radiology case. This masseteric hypertrophy is asymptomatic and soft. Some authors associate it with the habit of chewing gum. Concurrent occurrence of masseter muscle hypertrophy along with medial pterygoid muscle makes it a rare entity which is difficult to diagnose clinically specially in the absence of oral manifestations.
Unilateral muscle hyperatrophy or atrophy can be well demonstrated either by computed. Masseter muscle hypertrophy is a rare condition of idiopathic cause. Background botulinum toxin type a btxa is widely used for the clinical treatment of masseteric hypertrophy. Pdf masseter muscle hypertrophy is defined as the unilateral or bilateral expansion of the masseter muscle, and little is known about its etiology find, read and cite all the research you. Aesthetic problems consist of prominent masseter muscle in the face. Management of unilateral masseter hypertrophy and hypertrophic. Limitations on mouth opening and also tension in the region of the hypertrophied muscle are symptoms reported.
Masseter hypertrophy is a rare condition and the etiology in the majority of the cases is unclear. Botulinum toxin for masseter reduction in asian patients. Botulinum toxin type atreatment for contouring of the. Several treatment options reported for masseter hypertrophy are present, which range from simple pharmacotherapy to more invasive. Oct 07, 2018 the surgical solution for masseter hypertrophy is to cut out a portion of the masseter muscle with or without reduction of any thickened underlying bone. Masseter muscle hypertrophy occurs as a soft enlargement of the jaw muscles near the angle of the lower jaw and seldom presents a major health problem. Toxin masseter injections have a high efficacy and safety profile, but the risks of a variety of side effects or complications remain. The masseter is a facial muscle and lies in front of the ear and connects the top portion of the upper jaw zygomatic arch and maxilla to the lower portion of the bottom jaw coronoid process, ramus of mandible. Apr 29, 2020 masseter muscle is a paired, strong, thick and rectangular muscle that is originating from the zygomatic arch down to the mandibular angle. The masseter muscle hypertrophy is the muscle s uni or bilateral excessive development leading, in the majority of the cases, to an aesthetic discomfort to the patients1. The masseter arises from the zygomatic bone cheekbone and is inserted at the rear of the mandible jawbone.
Earlier, masseter muscle reduction needed to be performed through plastic surgery, but now a nonsurgical injection based cosmetic procedure with botox can treat masseter hypertrophy. Botulinum toxin type a application is most commonly used for the treatment because of its less invasive feature. Masseter definition of masseter by medical dictionary. This disorder has been described in the otolaryngological and surgical literature. A total of five patients with unilateral or bilateral masseter muscle hypertrophy were treated at the department of oral and maxillofacial surgery at nair hospital dental college, mumbai, india.
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