• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제43권1호
• /
• pp.46-48
• /
• 2017

A patient, who underwent partial masseter muscle resection and mandibular angle reduction at a plastic surgery clinic, visited this hospital with major complaints of trismus and dysesthesia. A secondary angle formation due to a wrong surgical method was observed via clinical and radiological examinations, and the patient complained of trismus due to the postoperative scars and muscular atrophy caused by the masseter muscle resection. The need for a masseter muscle resection in square jaw patients must be approached with caution. In addition, surgical techniques must be carefully selected in order to prevent complications, and obtain effective and satisfactory surgery results.

• 대한두경부종양학회지
• /
• 제33권1호
• /
• pp.79-83
• /
• 2017

Hemangioma is the most common benign tumor in neonatal and infant stage. In the head and neck region, the lesion mostly occurs in the masseter, trapezoidal or sternocleidomastoid muscle. Due to its rarity and non-specific symptoms, it is difficult to diagnose precisely. Intramuscular hemangioma can be misdiagnosed as sialolithiasis of the parotid gland. There are several treatment options for hemangiomas such as sclerotherapy, radiotherapy, embolization, and surgery. Of all these, definitive surgical resection is considered most effective in preventing future recurrence. Here we report a case of intramuscular hemangioma that was detected in the patient's right masseter muscle which was initially misdiagnosed as parotid sialolithiasis and was consequently managed with surgical resection.

• 대한두개안면성형외과학회지
• /
• 제20권6호
• /
• pp.388-391
• /
• 2019

Schwannoma is a slow-growing, well-demarcated, benign soft tissue tumor of the peripheral nerve sheath. It commonly develops in the head and neck region, usually in the parapharyngeal space. In this case, a 42-year-old woman visited the outpatient department to manage a painless mass on her left cheek. She had no history of concern and no neurological symptoms were observed. In the enhanced computed tomography scan, a 2.8×2.8×1.8 cm, heterogeneously enhanced tumor was detected in the left masseter muscle. A tumor resection under general anesthesia was planned. For the resection, a facelift incision was chosen; branches of the facial nerve were identified and retrogradely dissected. A well-marginated, yellowish, solid mass was found in the left masseter muscle. The mass was excised and given a histopathological diagnosis of schwannoma. A definite diagnosis of schwannoma, originating in the masseter muscle, is difficult to arrive at with radiographic findings alone; it is often misdiagnosed as intramuscular hemangioma. Histopathological examinations, including fine-needle aspiration or histological biopsy after surgery, are necessary. Using a facelift incision with retrograde facial nerve dissection, tumor resection in an intramasseteric lesion can be performed efficiently, without nerve damage, or leaving conspicuous scars on the face.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제43권2호
• /
• pp.125-133
• /
• 2017

Intramuscular hemangioma (IMH) is a rare vascular disease involving skeletal muscle, comprising only 0.8% of hemangiomas. About 10% to 15% of IMHs occur in the head and neck region, mostly involving the masseter muscle. IMH occurs mostly in childhood, but is often not found until unexpected enlargement, pain, or cosmetic asymmetry occurs in adulthood. Several non-surgical treatments including cryotherapy, sclerosant injection, and arterial ligature have been described, but complete surgical resection is the curative intervention. In this report, we present two rare cases of IMH. One IMH case in a 48-year-old male occurred in the masseter muscle feeding from the transverse facial artery. Embolization of the distal branch of the facial artery was first conducted, and then the buccal mass was removed surgically via the intraoral approach. A second IMH case in a 58-year-old female occurred in the orbicularis oris muscle feeding from the superior labial artery, and the mass was excised surgically without embolization.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제43권3호
• /
• pp.191-196
• /
• 2017

Squamous cell carcinoma of the buccal mucosa has an aggressive nature, as it grows rapidly and penetrates well with a high recurrence rate. If cancers originating from the buccal mucosa invade adjacent anatomical structures, surgical tumor resection becomes more challenging, thus raising specific considerations for reconstruction relative to the extent of resection. The present case describes the surgical management of a 58-year-old man who presented with persistent ulceration of the mucosal membrane and a mouth-opening limitation of 11 mm. Diagnostic imaging revealed a buccal mucosa tumor that had invaded the retroantral space upward with involvement of the anterior border of the masseter muscle by the lateral part of the tumor. In this report, we present the surgical approach we used to access the masticator space behind the maxillary sinus and discuss how to manage possible damage to Stensen's duct during resection of buccal mucosa tumors.

• 대한두개안면성형외과학회지
• /
• 제22권2호
• /
• pp.115-118
• /
• 2021

Intramuscular hemangioma is a rare vascular benign proliferation that can occur within any muscle, particularly in the trunk and extremities. In the head and neck region, the masseter muscle is most commonly involved, followed by the periorbital and sternocleidomastoid muscles. Diagnosing intramuscular hemangioma is challenging because there are no characteristic symptoms; instead, magnetic resonance imaging is the best imaging modality to diagnose these lesions. Complete surgical resection is the treatment of choice, although the local recurrence rate is high. Herein, we report a rare case of intramuscular hemangioma located in the zygomaticus minor muscle, which is related to smiling and usually runs along the orbicularis oculi muscle. Distinguishing or separating these two muscles is challenging. However, based on the muscle vector of the midface and radiological findings, the two muscles were successfully separated. The zygomaticus minor was cut very slightly to approach to the lesion and the muscle fibers were split to excise it. A follow-up examination revealed no nerve damage or muscle dysfunction at 4 weeks postoperatively. This rare case may serve as a reference for managing intramuscular hemangioma in the head and neck region.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제38권2호
• /
• pp.116-120
• /
• 2012

The buccal fat pad is specialized fat tissue located anterior to the masseter muscle and deep to the buccinator muscle. Possessing a central body and four processes it provides separation allowing gliding motion between muscles, protects the neurovascular bundles from injuries, and maintains facial convexity. Because of its many advantageous functions, the use of the buccal fat pad during oral and maxillofacial procedures is promoted for the reconstruction of defects secondary to tumor resection, and those defects resulting from oroantral fistula caused by dento-alveolar surgery or trauma. We used the pedicled buccal fat pad in the reconstruction of intraoral defects such as oroantral fistula, maxillary posterior bone loss, or defects resulting from tumor resection. Epithelization of the fat tissue began 1 week after the surgery and demonstrated stable healing without complications over a long-term period. Thus, we highly recommend the use of this procedure.

• 대한소아치과학회지
• /
• 제23권2호
• /
• pp.559-574
• /
• 1996

The purpose of this study was to determine whether there was any correlation between temporomandibular joint dysfunction and structure of the mandibular condyle. Weanling rats had their masseter muscles resected and immunohistochemical findings were observed with a light microscope. The results obtained were as follows : 1. The condylar cartilage region was divided into articular, proliferating, cartilage cell and hypertrophic cell layers according to cell morphology. 2. In light microscopic views, the proliferating and cartilage cell layers of the experimental group decreased gradually and at the 8th week significantly. 3. In immunohistochemical staining for type I and II collagen, a reaction was detected in the lower part of proliferating cell and cartilage cell layers. In the cartilage cell layers, a stronger cellular reaction was present. Immunohistochemical staining for type II collagen reacted more strongly than that of type I collagen. 4. In immunohistochemical staining for proteoglycan, the staining of the experimental group resembled the control group and gradually showed a weak reaction. The proliferating and cartilage cell layers reacted more strongly than the hypertrophic cell layer. 5. In immunohistochemical staining for proliferating cell nuclear antigen(PCNA), the strong reaction was detected in the nucleus of the proliferating cell layer both in control and experimental groups. But the thickness of the proliferating layer decreased in experimental group, consequently the reaction of the experimental group was reduced more than that of the control group.