Citation, DOI, disclosures and article data
Citation:
Elfeky M, Ibrahim D, Bell D, et al. Masticatory muscle hypertrophy. Reference article, Radiopaedia.org (Accessed on 25 Apr 2024) https://doi.org/10.53347/rID-66563
Masticatory muscle hypertrophy, also known as - and commonly presenting as - temporalis and masseter muscles hypertrophy, is a rare condition that affects the muscles of mastication and results in "pseudomasses". 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 morphopsychological conflict in a gentle individual resulting in the "minotaur syndrome" 9. It can also involve the lateral and medial pterygoid muscles.
The age of the patients ranges from 15 to 65 years with involvement of both sexes 3.
Commonly presents with bilateral cheeks and temporal swelling. It most commonly occurs bilaterally. Unilateral occurrence and isolated temporalis/masseter enlargement has also been reported but is rare 1.
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.
Treatment and prognosis
Conservative management is usually considered in mild cases. Surgical options are warranted in cases complaining of facial disfigurement and those who develop psychological problems (e.g. minotaur syndrome) due to their facial appearance 9.
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1. Abrams J. [Hypertrophy of the masseter muscle. Clinical aspects--etiology--therapy]. (1989) Laryngo- rhino- otologie. 68 (7): 383-7. doi:10.1055/s-2007-998359 - Pubmed
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2. Ozturk E, Mutlu H, Sonmez G, Sildiroglu HO, Basekim CC, Kizilkaya E. Unilateral temporalis muscle hypertrophy with contralateral masseteric hypertrophy. (2007) Dento maxillo facial radiology. 36 (5): 296-7. doi:10.1259/dmfr/12003200 - Pubmed
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3. Ranasinghe JC, Wickramasinghe C, Rodrigo G. Isolated unilateral temporalis muscle hypertrophy in a child: a case report with literature review. (2018) BMC pediatrics. 18 (1): 71. doi:10.1186/s12887-018-1061-7 - Pubmed
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4. Arzul L, Corre P, Khonsari RH, Mercier JM, Piot B. [Asymmetric hypertrophy of the masticatory muscles]. (2012) Annales de chirurgie plastique et esthetique. 57 (3): 286-91. doi:10.1016/j.anplas.2012.02.014 - Pubmed
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5. Graziano P, Dell'Aversana Orabona G, Astarita F, Ponzo LM, Nunziata R, Salzano G, Maglitto F, Solari D, Santella A, Cappabianca M, Iaconetta G, Califano L. Bilateral hypertrophy of masseteric and temporalis muscles, our fifteen patients and review of literature. (2016) European review for medical and pharmacological sciences. 20 (1): 7-11. Pubmed
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6. Pary A, Pary K. Masseteric hypertrophy: considerations regarding treatment planning decisions and introduction of a novel surgical technique. (2011) Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 69 (3): 944-9. doi:10.1016/j.joms.2010.06.205 - Pubmed
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7. Chrispal A, Boorugu HK. Benign masticatory muscle hypertrophy. (2009) The Journal of the Association of Physicians of India. 57: 764. Pubmed
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8. Morselli PG. Temporalis muscle hypertrophy: a new plastic surgery procedure. (2000) Plastic and reconstructive surgery. 106 (5): 1156-61. Pubmed
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9. Morselli PG. The Minotaur syndrome: plastic surgery of the facial skeleton. (1993) Aesthetic plastic surgery. 17 (2): 99-102. doi:10.1007/BF02274728 - Pubmed
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