Masticatory muscle hypertrophy
Masticatory muscle hypertrophy or commonly presenting as temporalis and masseter muscles hypertrophy is a rare disease that affects muscles of mastication and results in "pseudo-masses". Commonly seen in anxious individuals with "bruxism" and in chronic gum chewing 1.
It sometimes gives a "threatening" appearance to the face that can create morpho-psychological conflict in a gentle individual resulting in the "minotaur syndrome". It can also involve the pterygoid muscles.
Commonly presents with bilateral cheeks and temporal swelling. It is most commonly occurs bilaterally. Unilateral occurrence and isolated temporalis/masseter enlargement has also been reported but is rare 1. The age of the patients ranges from 15 to 65 years with involvement of both sexes 3.
It appears in imaging as muscle hypertrophy with uniformly increased muscle bulk and preserved signal intensity. The value of imaging in diagnosis is to exclude other causes of facial swelling like tumors, especially if unilateral.
Conservative management is usually considered in mild cases. Surgical options are warranted in cases complaining of facial disfigurement and those who developed psychological problems due to their facial appearance.
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