1/39. Electromyographic activity of the jaw-closing muscles before and after unilateral coronoidectomy performed on a patient with coronoid hyperplasia: a case study.There have been few reports analyzing the activity of the jaw-closing muscles after coronoidectomy performed on a patient with coronoid hyperplasia. This paper presents a case study using electromyograms (EMGs) to evaluate the effects of unilateral coronoidectomy on the activity of masseter and temporal muscles. The patient was a 25-year-old male whose maximal range of jaw opening was 24 mm. After coronoidectomy of the left region, the range improved to 43 mm. EMGs were recorded in the center of the masseter muscles and the anterior part of the temporal muscles during gum chewing. Preoperatively, no abnormal EMG activity was observed. Eight months after surgery, increase in the ratio of the bilateral temporal muscle activity and a decrease in the ratio of the right masseter muscle activity were observed, and the proportion of activity of jaw closing muscles was out of the normal range. Eighteen months after surgery, there was slight return to the preoperative EMG activity. It was concluded that unilateral coronoidectomy could result in EMG changes of masseter and temporal muscles with a gradual return.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
2/39. Moebius syndrome: the new finding of hypertrophy of the coronoid process.The first detailed description of congenital facial paralysis was reported by Moebius in 1888. It is characterized by either unilateral or bilateral paralysis of the facial muscles and an associated abducens palsy. The present report is of two patients with Moebius syndrome, who were also diagnosed with trismus at birth. Each patient also demonstrated bilateral hypertrophy of the coronoid process of the mandible. In effect, the zygoma obstructed the excursion of the mandible because of a "coronoid block." A three-dimensional computed tomography scan demonstrated normal temporomandibular joints but bilateral hypertrophy of the coronoid processes and micrognathia. Both patients demonstrated less than 10 mm of oral excursion. Bilateral coronoidectomies were performed through an intraoral approach. The oral excursions after surgery increased to at least 20 mm. In each of these patients, the coronoid process was enlarged relative to the zygoma, which was of normal size and configuration. The trismus was associated with blocking of the coronoid by the anterior zygoma, preventing open or full excursion of the hypoplastic mandibles. Moebius syndrome can have a variable presentation at birth. In two patients, the authors describe a new finding of hypertrophy of the coronoid process and trismus secondary to obstruction of the coronoid by the hypertrophic zygomas during oral excursions. Each patient is described, and a review of the literature is discussed.- - - - - - - - - - ranking = 0.083333333333333keywords = muscle (Clic here for more details about this article) |
3/39. Anaesthetic management of two paediatric patients with Hecht-Beals syndrome.We undertook the anaesthetic management of two children with Hecht-Beals syndrome for orthopaedic surgery under general anaesthesia. Both patients had arachnodactyly, kyphoscoliosis, and multiple congenital joint contractures, but limited mandible excursion was not obvious preoperatively in either, although mental retardation made it difficult for them to cooperate with mouth examination. They had no apparent difficulties with their mouths in daily activities. The anaesthesia records of one patient showed that intubation had been difficult in an earlier procedure. The other patient also had a history of difficult intubation, with slight tearing of the corners of her mouth during an intubation procedure. During slow induction of general anaesthesia with sevoflurane, face mask ventilation was easily performed. We attempted to visualize the larynx under anaesthesia with muscle relaxation, but we were unsuccessful because of the limited mouth opening. After several trials, blind oral intubations were fortunately successful in both patients. There were no postoperative problems with the airway.- - - - - - - - - - ranking = 0.083333333333333keywords = muscle (Clic here for more details about this article) |
4/39. Recurrent steroid-responsive trismus and painful ophthalmoplegia.A 63-year-old woman experienced two episodes of trismus and painful ophthalmoplegia at an interval of six years. She suffered left visual loss, and enhanced CT scan and MR imaging revealed heterogeneous enlargement of the left extraocular muscles extending to the orbital apex. In addition, the left pterygopalatine fossa was filled with a mass isointense with muscle without evidence of surrounding tissue invasion; 67Ga scintigraphy showed high uptake in this lesion. Steroid administration dramatically resolved the trismus, and the mass in the orbit and extraorbit vanished completely. orbital pseudotumor is characterized by self-limited, relapsing, steroid-responsive painful ophthalmoplegia, and this case could be a variant of this entity with inflammation extending into the extraorbital area.- - - - - - - - - - ranking = 0.16666666666667keywords = muscle (Clic here for more details about this article) |
5/39. Difficult tracheal intubation following midface distraction surgery.A case of difficult intubation in a patient with Apert syndrome, who had recently undergone bilateral internal midface distraction, is described. The 14-year-old boy had no antecedent history of such difficulty, despite numerous previous anaesthetics. We suggest that trismus due to temporalis muscle fibrosis, and the altered relationships of the maxilla and mandible following midface advancement, were causal.- - - - - - - - - - ranking = 0.083333333333333keywords = muscle (Clic here for more details about this article) |
6/39. Congenital trismus secondary to masseteric fibrous bands: endoscopically assisted exploration.The authors present an 18-month-old female infant with congenital trismus. Computed tomography and magnetic resonance imaging were not helpful in determining the cause. A surgical endoscope was used to explore her temporomandibular joints and temporal fossae, thus avoiding the morbidity of a bicoronal incision. The cause was bilateral fibrous bands on the anterior border of the masseter muscles. Incision of these fibrous bands led to relief of the trismus. This finding is consistent with a previously described variant of the Hect-Beals-Wilson trismus-pseudocamptodactyly syndrome. This patient, however, had no evidence of the autosomal dominant inheritance pattern nor did she exhibit pseudocamptodactyly, both of which are generally ascribed to this syndrome. Unfortunately the trismus recurred 3 months postoperatively.- - - - - - - - - - ranking = 0.083333333333333keywords = muscle (Clic here for more details about this article) |
7/39. trismus resulting from central nervous system lesion.Three cases of unusual trismus are reported, occurring in patients with lesions of the central nervous system. On the basis of the clinical and electromyographical findings and observation of the course of the trismus this is interpreted as a symptom of a lesion of the brain stem, causing a dis-synergism of the masticatory muscles.- - - - - - - - - - ranking = 0.083333333333333keywords = muscle (Clic here for more details about this article) |
8/39. Hemimasticatory spasm associated with localized scleroderma and facial hemiatrophy.OBJECTIVES: To report a case and discuss the mechanism of hemimasticatory spasm. DESIGN: Case report. PATIENT: A 37-year-old woman had a 3-year history of involuntary spasms of the right masseter muscle in association with localized scleroderma and facial hemiatrophy. Electrophysiological studies revealed a normal blink reflex. However, the masseter reflex and silent period were absent on the affected side. Distal latency and compound muscle action potential of the masseter nerve were normal. Needle electromyography demonstrated irregular bursts of motor unit potentials similar to those described in hemifacial spasm. A magnetic resonance imaging scan of the head showed mild hypertrophy of the masseter muscle and atrophy of subcutaneous fatty tissues on the affected side. Local injection of botulinum toxin A into the masseter muscle resolved the patient's symptoms. CONCLUSION: On the basis of clinical and electrophysiological findings, focal demyelination of motor branches of the trigeminal nerve owing to deep tissue changes is suggested as the cause of abnormal excitatory electrical activities resulting in involuntary masticatory movement.- - - - - - - - - - ranking = 0.33333333333333keywords = muscle (Clic here for more details about this article) |
9/39. Pseudoankylosis of the mandible as a result of methyl methacrylate-induced inflammatory cicatricial contracture of the temporal muscle after cranioplasty.Pseudoankylosis of the mandible after intracranial surgical procedure has been widely reported, and is usually caused by fibrosis of the temporal muscle as a result of injury during the operation. We present an unusual case of mandibular pseudoankylosis as a result of methyl methacrylate-induced aseptic inflammatory cicatricial contracture of the temporal muscle after cranioplasty.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
10/39. myositis ossificans traumatica of the temporal muscle: a case report.myositis ossificans traumatica (MOT) is a pathological condition characterized by extraskeletal formation of bony tissue, induced by violent or repeated trauma. Reports of this pathology occurring in the region of the head and neck are rare, and even more so in the muscles of mastication. We present the case of patient with MOT of the temporal muscle, the etiology of which seems to be related to traumatic manipulations during dental treatment. A review of the literature is presented and the surgical approach, which resolved this case is discussed.- - - - - - - - - - ranking = 0.5keywords = muscle (Clic here for more details about this article) |
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