• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권5호
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• pp.473-479
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• 2008

Asians tend to have prominent mandibular angle. The causes of wide lower third of the facial contour are obtuse mandibular angle and hypertrophy of masseter muscles. In cases of hypertrophy of masseter muscles, conventional treatment intends to the contraction of masseter muscle. Recently, volumetric reduction of masseter muscles using botulinum toxin type A injection and radiofrequency (RF) reduction have been introduced. The use of RF energy for masseter muscle reduction is known as a safe, simple, and effective method for aesthetic lower facial contouring. The purpose of this study is to present the effects of RF reduction applied to hypertrophy of masseter muscles, to review and to encourage RF practices in oral and maxillofacial region.

• Archives of Plastic Surgery
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• 제38권2호
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• pp.173-181
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• 2011

Purpose: Masseter muscle is an important muscle of mastication. Because it has a great influence on the shape of low facial contour, patients who have masseteric hypertrophy show square-shaped jaw appearance. As aesthetic procedures for the reduction of the masseter muscle volume, radiofrequency ablation or botulinum toxin injection is at the center of attention. Authors studied the anatomical measurement of the thickness and width of masseter muscle and the surface mapping of the maximal thickness point using computed tomography (CT) scan to identify the useful guide for the injection of botulinum toxin in masseteric hypertrophy patients. Methods: We analyzed 2 mm-thickness OMU (ostiomeatal unit) CT of 112 normal people (224 masseter muscles) taken from June 2009 to May 2010. First, we measured the thickness, width and depth of the masseter muscle from the skin surface and analysed each by side, sex and age, respectively. The distribution of the thickness of the muscle and the correlation of thickness and width of the muscle were studied also. Second, we underwent surface mapping of the maximal thickness point using CT analysis by means of checking the vertical and horizontal distance from the angle of the mandible. Results: The average thickness and width of the masseter muscle was 17.73 mm and 40.78 mm in the male patients and were 14.33 mm and 37.42 mm in the female patients. Statistically, both figures of the male patients were larger than those of the female patients. However, the depth of the muscle from the skin surface in female patients (7.37 mm) was larger than that of the male patients (6.15 mm). There were no statistical difference in side or age. The width and thickness of the masseter muscle were in the positive correlation. The location of maximal thickness point of the masseter muscle was 27.77 mm vertically and 27.68 mm horizontally in the male patients, and 25.19 mm vertically and 25.42 mm horizontally in the female patients from the angle of mandible. Conclusion: We were able to present statistical evidence of the diagnosis and treatment of the masseteric hypertrophy regarding the anatomical measurements such as the thickness and width. And the maximal thickness point of the masseter muscle may be a useful guide for the clinical procedures of botulinum toxin injection.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권2호
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• pp.215-219
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• 1999

This article discusses the diagnosis, anatomic consideration, and surgical management of masseter muscle hypertrophy. Surgical correction is advised for patients who have esthetic complaints. Esthetic improvement can be achieved by surgery and not by conservative treatment. Recently, the intraoral method, which leaves no scar on the face and minimizes the possibility of injury to the marginal branch of the facial nerve, has been supported by many surgeons. Patients who complained of marked swelling of unilateral or bilateral mandibular angle area and showed abnormal bony growth at the mandibular angle area and enlarged masseter muscle received mandibular angle shaving and excision of the inner layer of masseter muscle with intraoral approach. After operation, physiotherapy was done with EAST(eletrical acupuncture stimulation therapy) for encouraging the mouth opening and reducing the swelling. They showed early maximum mouth opening and reduction of swelling.

• 구강회복응용과학지
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• 제27권2호
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• pp.247-251
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• 2011

교근비대 환자들은 그들의 각진 턱을 심미적으로 개선시키기 위해 교근 두께를 줄이기를 희망한다. 과거엔 수술적인 방법이 널리 알려져 왔지만 최근 양측으로 주사하는 보톡스 시술이 수술에 비해 덜 침습적이기에 그 대안으로 관심이 대두되고 있다. 이 연구의 목적은 기존의 양측성 교근비대에서 양측에 동량을 주사하는 방법과 달리 편측성 교근비대 환자에서 보툴리눔 독소를 편측으로만 주입 후 삼차원 레이저스캐너를 이용하여 안모의 부피변화를 측정하고자 하였다. 삼차원 레이저스캐너를 이용하여 술전에 편측성 교근비대 환자 10명의 하안모 부피를 측정한 후, 편측으로 보툴리눔 A형 독소 주사 25U이 주사되었다. 주사 4주, 8주, 12주 후 같은 방법으로 하안모의 부피를 측정한 뒤 술전의 삼차원 사진과 중첩하여 변화된 부피를 측정하였다. 주사한 쪽의 부피는 술전에 비해 보툴리눔 독소 주사 4주, 8주, 12주 후 현저히 줄어들었으며 통계학적으로 유의미한 결과를 보였다. 반면 주사안한 쪽의 부피는 특기할 변화가 없었다. 따라서 편측성 교근비대 환자에서 편측 보툴리눔 독소 주사 후 주사한 쪽의 부피가 현저히 감소하여 근육성 비대칭 환자에서 편측 보툴리눔 독소 주사가 심미적 개선에 도움을 줄 수 있을 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• 제41권1호
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• pp.26-29
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• 2016

Intramuscular hemangioma is a rare type of hemangiomas and sometimes overlooked by orofacial pain specialist who encountered various types of masticatory muscle problems. A 42-year-old male, presented with feeling of unilateral hypertrophy on left mandibular area, is finally diagnosed as hemangioma with thrombus by excisional biopsy. However, he was initially treated by injection of botulinum toxin A due to misdiagnosis as unilateral masseter hypertrophy. In the present report, we remind the importance of careful examination and diagnostic images to orofacial pain clinicians in early detection of intramuscular hemangioma of masticatory muscles.

• 대한통합의학회지
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• 제8권3호
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• pp.93-101
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• 2020

Purpose : Temporomandibular joint disorder (TMJD) is often accompanied by pain and limited range of motion of the jaw joint, which affect patients' quality of life and result in hypertrophy or hyperactivity of the muscles around the jaw joint. In this study, we compared the muscle thickness and tone of the masseter and sternocleidomastoid (SCM) muscles and the jaw range of motion in individuals with and without TMJD. Correlation comparison was performed on the results of the TMJD group. Methods : This study included 40 patients; 20 patients were assigned to an experimental group (TMJD group) and 20 to a control group (non-TMJD group). Ultrasonography, myotonometry, and measurements performed with digital Vernier calipers were used to determine the changes in muscle thickness, muscle tone, and maximum jaw opening, respectively. The independent t-test was used for intergroup comparison of data, and Pearson correlation coefficients were used to compare correlations in the TMJD group results. Results : We observed a significant intergroup difference in the masseter and SCM thickness during the relaxed and clenched phases (p<.05). A significant intergroup difference was also observed in maximum jaw opening (p<.05). With regard to muscle tone, we observed a significant intergroup difference in frequency (p=.011) and stiffness (p=.011) of the masseter, as well as in the frequency (p=.009) and stiffness (p=.026) of the SCM. We observed a moderate negative correlation (r=-.524) between maximum jaw opening and the frequency of the masseter. Additionally, we observed a moderately negative correlation between jaw opening and muscle stiffness (r=-.321). Conclusion : Planning exercise programs to treat patients with TMJD who present with pain should focus on efforts to reduce muscle thickness and achieve muscle relaxation (to reduce muscle tension) for improved jaw range of motion.

• 대한치과교정학회지
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• 제47권4호
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• pp.222-228
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• 2017

Objective: To evaluate soft- and hard-tissue changes in the mandibular angle area after the administration of botulinum toxin type A (BoNT-A) injection to patients with masseteric hypertrophy by using three-dimensional cone-beam computed tomography (3D-CBCT). Methods: Twenty volunteers were randomly divided into two groups of 10 patients. Patients in group I received a single BoNT-A injection in both masseter muscles, while those in group II received two BoNT-A injections in each masseter muscle, with the second injection being administered 4 months after the first one. In both groups, 3D-CBCT was performed before the first injection and 6 months after the first injection. Results: Masseter muscle thicknesses and cross-sectional areas were significantly reduced in both groups, but the reductions were significantly more substantial in group II than in group I. The intergonial width of the mandibular angle area did not change significantly in either group. However, the bone volume of the mandibular gonial angle area was more significantly reduced in group II than in group I. Conclusions: The repeated administration of BoNT-A injections may induce bone volume changes in the mandibular angle area.

• Archives of Plastic Surgery
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• 제32권3호
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• pp.311-313
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• 2005

Generally, many Asian women tend to dislike the square jaw, as they believe it makes the face look wider, giving a stubborn and strong impression. Contouring of the mandible is therefore a relatively common aesthetic procedure among Asians. These days, the use of botulinum toxin for contouring of the lower face offer simple alternative to surgery. Motor point, which is the site over a muscle where its contraction may be elicited by a minimal intensity short duration electrical stimulus, is the optimal injection point of botulinum toxin. Study was undertaken to identify the location of motor point of the masseter muscle and the skin surface landmark. First, the thickest point of the masseter muscle was inspected through palpation and inspection by 3 different individual plastic surgeons and then compound muscle action potentials(CMAPs) of masseter muscle in 15 health volunteers were recorded using EMG. For the localization of the measured points, line between lateral canthus to the mandibular angle was used. Location of motor points were mapped to skin surface from lateral canthus in a percentage of the distance along the landmark line and in distance in millimeters. The clinical injection point was located at 71.69 percentile and 7.3 mm of the landmark line. The motor point test was located at 72.54 percentile and 7.1 mm of the landmark line. The depth of motor point was 16mm. There was no statistically significant difference between the clinical injection point and the motor point. We conclude that surface mapping of motor point of the masseter muscle would increase accessibility and accuracy in botulinum toxin injection for contouring of the lower face.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권2호
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• pp.74-80
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• 1989

교근의 편측성 혹은 양측성 비후로 정의되는 이 질환은 원인은 분명치 않으나, 아마도 선천적이고 유전적으로 결정되는 비정상으로 알려져 있고 이외에도 교합과의 관련성, 심리학적 분석등의 관련성도 논의되어 졌다. 감별시는 부위적 특성으로 이하선 질환과의 구별이 요하나 임상적 및 방사선 검사에서 어렵지 않게 진단이 가능하며 치료로는 심미적인 문제로 인해 외과적인 절제가 최선의 치료이고 외과적 절제시에는 하악지의 형태에 대한 평가와 비후된 교근의 부위에 따른 적절한 수술법 선택이 요하며, 아직까지 재발에 관한 보고는 없으나 관찰이 요구된다.

• 대한치과의사협회지
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• 제15권3호
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• pp.205-208
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• 1977

The etiology of masseteric hypertrophy is obscure. When the hypertrophy occurs unilaterally it's appearance is more striking because of the resultant facial asymmetry. Two soldiers were admitted with the complaint of a lump on their jaws. The authors obtained good results on the esthetic & functional aspect in two cases of unilateral masseteric hypertrophy with the Adam's method. The etiology was thought to be the combination of unilateral masticatory and jaw clenching habits when emotionally disturbed or under nervous tension in army services.