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Superiorly based and island masseter muscle flaps for repairing oropharyngeal defects.

INTRODUCTION: Tumours of the posterior part of the mouth and/or the oropharynx are often diagnosed at advanced stages. Reconstruction in this region has advanced considerably during the last three decades. Although microsurgery has offered major progress and has obviously improved the patients' outcome, the use of local and regional flaps generally remains an ideal solution for reconstruction. MATERIAL AND METHODS: Between January 1994 and December 2001, the defects resulting from resection in 22 out of 38 patients with retromolar and/or anterior faucial pillar squamous cell carcinomas treated at this institution, were repaired by one of two types of masseter muscle flaps. The first type is the superiorly based or cross-over masseter muscle flap, and the second type the island muscle flap (being a modification of the first type). RESULTS: The superiorly based masseter muscle flap was used in 12 patients and the island masseter muscle flap in 10. Both techniques offer a quick and reliable method for repairing oropharyngeal defects in oncologically "safe" cases. Neither require elaborate technique or aftercare. CONCLUSION: The island masseter muscle flap has an advantage over the superiorly based masseteric flap, as it is more flexible, pliable for larger defects, and causes no postoperative trismus.

Adult↗

Paralyzed masseter muscle reinnervation by facial nerve implantation or anastomosis: a comparative study in rabbits.

OBJECTIVE: To investigate the changes in the physiological and structural properties of the masseter muscle after reinnervation through different reinnervation methods. METHOD: Twenty-four adult rabbits were randomly divided into groups A and B (n=12) after the establishment of masseter muscle paralysis, followed by facial nerve anastomosis with the masseteric nerves in group A and facial nerve implantation into the masseter muscle in group B. At 1, 3 and 6 months after the operation, gross observation and wet weight measurement of the muscles were conducted along with myoelectric activity and enzyme- histochemical analyses and ultrastructural observation as well. RESULTS: The reinnervation of the masseter muscle by both facial nerve anastomosis and implantation was confirmed and the muscles recovered their motion of contraction activity. Changes took place in the histochemical types of the muscle fibers, which tended to assume the properties typical of facial muscles. Three months after the operation, the muscle fiber conduction velocity recovery after the reinnervation by the two methods was significantly different (P<0.01), but not so till 6 months postoperatively (P>0.05). CONCLUSION: This two methods are both effective in the reinnervation of the muscles, but in one-stage operation, intramuscular nerve implantation is relatively less complicated in operation and causes less damage while producing similar effects to that by nerve anastomosis.

Anastomosis, Surgical↗

Histological study of rat masseter muscle following experimental occlusal alteration.

It has been suggested that occlusal interference results in masticatory muscle dysfunction. In our previous study, occlusal interference reduced the rat masseter energy level during masticatory movements. The purpose of this study was to investigate the histological alterations of rat masseter muscles following experimental occlusal alteration with unilateral bite-raising. A total of eight male adult Wistar rats were equally divided into control and experimental groups. The experimental rats wore bite-raising splints on the unilateral upper molar. However, 4 weeks after the operation, the anterior deep masseter muscles were removed and then stained for succinic acid dehydrogenase (SDH), haematoxylin eosin (HE) and myofibrillar ATPase. Most of the muscle fibres in experimental rats remained intact, although partial histological changes were observed, such as extended connective tissue, appearance of inflammatory cells in the muscle fibres and existence of muscle fibres with central nuclei and central cores. Moreover, the fibre area-fibre frequency histograms of experimental muscle indicated a broad pattern than that of controls. These results indicated that occlusal interference caused histological changes in masseter muscles and that this may be related to the fact that the masseter energy level was reduced during masticatory movements in unilateral bite-raised rats.

Animals↗

Differential activation of neuromuscular compartments in the rabbit masseter muscle during different oral behaviors.

The rabbit masseter muscle is composed of multiple anatomical partitions that produce different mechanical actions. The purpose of this study was to test the hypothesis that these compartments are differentially activated during the performance of different oral behaviors. Rhythmic activation of the masticatory muscles was elicited by stimulating the cortical masticatory area (CMA) while recording forces generated at the incisors in three dimensions with the mandible immobilized. Torques about the right temporomandibular joint (TMJ) were calculated using these forces recorded during isometric function. A set of 1-15 unique rhythmic behaviors was identified for each rabbit using torque phase plot patterns. Electromyographic recordings were made at nine different compartments in the right masseter, two compartments in the left masseter, two regions in the right digastric, and single locations in the left digastric and right and left medial pterygoid muscles. In activation cycles producing similar mechanical actions, activity patterns at the 16 recording sites were clustered into three to six groups using principal component analysis (PCA). To test for similarities in the activation of masseter compartments, pair-wise comparisons of the PCA assignment for the nine masseter compartments were conducted and frequencies of common assignment were compiled for each unique rhythmic behavior for each rabbit. Masseter muscle compartments were found to vary significantly in their PCA from the expected distribution of 100% common principal component (PC) assignment (i.e., similar activation pattern). This finding is consistent with the independent activation of masseter compartments.

Animals↗

Expression of an embryonic fibronectin splicing variant in human masseter muscle.

Fibronectin is an extracellular matrix protein that is a key constituent of all skeletal muscles. Its deposition increases in a number of pathological conditions, including some muscular dystrophies in which a progressive increase in lower-face height is often noted. It has been shown in other organ systems that increased deposition of fibronectin is associated with changes in the expression of differentially spliced isoforms of the molecule. This investigation documents the expression of mRNA coding for fibronectin and its splicing variants, EIIIA and EIIIB, in biopsies of masseter muscle from normal and long-face patients, using reverse transcriptase-polymerase chain reaction. Expression was compared with that occurring in anatomically and embryologically differing somatic skeletal muscle. Masseter expressed fibronectin mRNA containing the EIIIA but not the EIIIB splicing variant. Conversely, somatic skeletal muscle expressed neither the EIIIA nor EIIIB variants. There were no differences between expression of fibronectin containing the EIIIA splicing variants in masseter from normal and long faces. These results suggest that variations in fibronectin expression reflect the differing functional demands of muscles from different anatomical locations and indicate that jaw and somatic muscle belong to different allotypes.

Base Sequence↗

Comparison of magnetic resonance imaging and gross findings regarding masseter muscle aponeuroses in cadavers.

OBJECTIVES: The main objective of this study was to compare the actual distribution and thickness of aponeuroses in cadavers with the distribution and thickness as determined by means of magnetic resonance imaging for the sake of evaluating magnetic resonance imaging as a diagnostic modality for assessing masseter muscle aponeuroses. STUDY DESIGN: The aponeuroses of 26 masseter muscles from 13 intact cadavers were examined by magnetic resonance imaging. RESULTS: The ratio of concordance between gross findings and magnetic resonance imaging findings was 99.0%, although depiction of thin parts of the aponeuroses on magnetic resonance imaging was poor. CONCLUSIONS: Magnetic resonance imaging was useful as a diagnostic modality in the assessment of masseter muscle aponeuroses. Aponeuroses were distributed throughout almost the entire masseter muscle, although almost no aponeuroses were seen below the lower half of the anterior margin. This was thought to be a characteristic finding of masseter aponeuroses.

Aged↗

Physiological identification and property of afferents from the masseter muscle to the caudal part of the trigeminal nucleus in rat.

The present study was to identify the physiological properties of the afferent fibers from the masseter muscle to the caudal part of the spinal trigeminal nucleus of rat using a microelectrode technique. When electrical stimulation was applied to the masseter muscle, the evoked potentials were recorded with a shorter latency (the S-response) or a longer latency (the L-response). The threshold current intensity of the S-response was lower than that of the L-response. There were statistical significant differences between the S-response and the L-response in latency and in threshold current intensity. Both the S- and L-responses could follow by stimulation of low frequencies (10 to 30 Hz), indicating that the evoked responses were the component of the secondary neuron activities. On the anatomical and physiological assumption, the conduction velocities of the S- and the L-responses were calculated and they were in the range of that of A-delta fibers. We also observed that both the S- and the L-responses could not follow high frequency stimulation of the masseter muscle. This effect may reflect the phenomenon of fatigue in the finely myelinated fibers or polymodal nociceptors. Thus, the present study suggested the involvement of the afferents from the masseter muscle to the spinal trigeminal nucleus in the transmission and the relay of the masticatory muscle pain.

Afferent Pathways↗

Substance P does not play a critical role in neurogenic inflammation in the rat masseter muscle.

In this study, we performed a series of experiments to investigate whether substance P (SP) contributes to neurogenic inflammation in the skeletal muscle tissue. Intramuscular injection of an inflammatory irritant, mustard oil (MO), induces significant edema formation in the rat masseter muscle. In order to study the contribution of endogenous SP in the MO-induced edema, groups of rats were pretreated with two different doses (100 nmol; 1 microl) of either peptidergic (Sendide) or non-peptidergic (L703, 606) neurokinin 1 (NK1) receptor antagonist in one masseter muscle 15 min prior to the MO injection in the same muscle. The extent of edema was assessed as the percent weight difference of the injected muscle compared to the non-injected muscle. Neither Sendide nor L703,606 pretreatment resulted in a significant inhibition of the MO-induced edema in the masseter muscle. Exogenous application of SP also produced a significant swelling of the muscle, which was blocked by L703,606 (1 microl) pretreatment, suggesting that evoked release of SP following MO injection is not sufficient to induce significant edema formation. Capsaicin (1% in 25 microl), which is known to cause neurogenic inflammation, failed to produce edema formation in the masseter muscle. The same concentration of capsaicin injected into the hindpaw produced significant swelling of the injected paw. Taken together, these results provide compelling evidence that, unlike cutaneous or joint tissue, SP does not play a critical role in inducing neurogenic inflammation in the skeletal muscle tissue.

Analgesics↗

Effect of treatment of dentofacial deformity on masseter muscle thickness.

OBJECTIVE: The objective of the present study was to determine the modifications in masseter muscle thickness before and after interdisciplinary orthodontic, oromyofunctional and surgical treatment of class III dentofacial skeletal deformities (DFSD). DESIGN: Fifteen patients with class III DFSD participated in the study, denoted P1 group before the interdisciplinary treatment and P2 group (same patients) 6-8 months after surgery. Fifteen individuals with no DFSD were used as the control group. Bilateral ultrasonography (US) of the masseter muscle under resting and biting conditions was performed in the three groups. RESULTS: There was a significant difference (P<0.01) for all muscles tested between the control, P1 and P2 groups, with greater thickness for controls, intermediate thickness for P2, and the lowest thickness for P1 in all situations evaluated. CONCLUSION: We conclude that there was an increase in masseter muscle thickness after surgical correction of DFSD accompanied by interdisciplinary treatment, although the values were still lower than those observed in the control group.

Adult↗

Masseter muscle hypertrophy.

Benign hypertrophy of the masseter muscle is an uncommon entity important in the differential diagnosis of head and neck masses, particularly a unilateral mass located in the cheek. Ten cases of benign masseteric hypertrophy are reviewed, current surgical treatment is described, and the pertinent literature is summarized.

Adolescent↗

Rhabdomyolysis of the masseter muscle: case report.

We describe a case of rhabdomyolysis involving the masseter muscle. It involved an episode of muscle lysis of the left upper and lower limb and the left masseter, after ingesting an unknown quantity of alcohol, amphetamines and ecstasy with prolonged immobility for an unknown period after collapse. Musculoskeletal sonography was used to diagnose rhabdomyolysis of the left masseter muscle.

Acute Kidney Injury↗

Transforming growth factor betas are upregulated in the rat masseter muscle hypertrophied by clenbuterol, a beta2 adrenergic agonist.

1. The regulatory mechanism for the hypertrophy of skeletal muscles induced by clenbuterol is unclear. The purpose of the present study was to determine the extent to which transforming growth factor betas (TGFbetas), fibroblast growth factors (FGFs), hepatocyte growth factor (HGF), and platelet-derived growth factors (PDGFs) are involved in the hypertrophy of rat masseter muscle induced by clenbuterol. 2. We measured the mRNA expression levels for TGFbetas, FGFs, HGF, and PDGFs in rat masseter muscle hypertrophied by oral administration of clenbuterol for 3 weeks and determined correlations between the weight of masseter muscle and mRNA expression levels by regression analysis. We determined immunolocalizations of TGFbetas and their receptors (TGFbetaRs). 3. The mRNA expression levels for TGFbeta1, 2, and 3, and for PDGF-B demonstrated clenbuterol-induced elevations and positive correlations with the weight of masseter muscle. In particular, TGFbeta1, 2, and 3 showed strong positive correlations (correlation coefficients >0.6). The mRNA expression levels for PDGF-A, FGF-1 and 2, and HGF showed no significant differences between the control and clenbuterol groups, and no significant correlations. TGFbeta1, 2, and 3 were principally localized in the connective tissues interspaced among myofibers, and TGFbetaRI and II were localized in the periphery and sarcoplasm of the myofibers. 4. These results suggest that paracrine actions of TGFbeta1, 2, and 3 via TGFbetaRI and II could be involved in the hypertrophy of rat masseter muscle induced by clenbuterol. This is the first study to document the involvement of TGFbetas in the hypertrophy of skeletal muscles induced by clenbuterol.

Adrenergic beta-Agonists↗

The influence of percussion, occlusion and mastication on the occurrence of silent periods in masseter muscle activity.

The occurrence of silent periods in masseter muscle activity was investigated during percussion of the bony structures of the head and neck, during occlusion of the teeth on surfaces of varying hardness, and during chewing of different food-stuffs. Silent periods were demonstrated on percussion during isometric and isotonic contraction of the masseter muscles and the occurrence of silent periods was influenced by the force of occlusion and by the nature of the surface contacted. Mandibular velocity was investigated during tapping and chewing sequences by ultra-high-speed cinematography, but it was not found possible to identify a critical change in mandibular velocity associated with the occurrence of silent periods. More silent periods were observed during the chewing of hard foods than of soft foods and there were more silent periods near the beginning of chewing sequences than towards the end. Differences in latency and duration of silent periods were observed in relation to artificial changes in the occlusion.

Dental Occlusion↗

Effect of occlusal splints on the electromyographic activities of masseter muscles during maximum clenching in patients with myofascial pain-dysfunction syndrome.

Integrated EMG activities of masseter muscles during maximum voluntary isometric contraction with and without full-arch maxillary stabilization splints were observed in patients with MPD syndrome having occlusal interferences and in healthy subjects having no occlusal interferences. The masseter muscle activity was more significantly reduced in patients with MPD syndrome during maximum clenching with splints than in those patients without splints. In healthy subjects, such a significant difference could not be observed with and without splints. This finding suggests that the elimination of the occlusal interferences by means of occlusal splints could reduce the degree of sensory information from the periodontal receptors during nocturnal clenching or grinding. This could result in a decrease in masseter muscle activity giving rise to muscular relaxation.

Action Potentials↗

Histochemical and functional fibre typing of the rabbit masseter muscle.

The fibre-type distribution of the masseter muscle of the rabbit was studied by means of the myosin-ATPase and succinate dehydrogenase reactions. Six different fibre types were found and these were unequally distributed between and within the anatomical compartments of the muscle. Most of the masseter consists of slow- and fast-twitch oxidative fibres. The slow fibres increase in numbers in the deeper and more anterior regions of the muscle. Fast-twitch glycolytic fibres were almost exclusively found in the most posterior portions of the superficial and deep masseter. The fibre composition within the sagittally orientated anatomical compartments was found to be correlated with maximal contraction speeds during natural mastication as estimated from a mechanical model. However, the differences in fibre composition between the anatomical compartments (and hence between superficial and deep layers) appeared not to be correlated with contraction speed. The regional and compartmental specialisation within the masseter permits the muscle to perform many different functional roles in the generation and control of the jaw movements, jaw position and bite forces.

Aerobiosis↗

A clinical and electromyographic study of the long-term effects of an occlusal splint on the temporal and masseter muscles in patients with functional disorders and nocturnal bruxism.

The postural activity of the temporal and masseter muscles in thirty-one patients with signs and symptoms of functional disorders were studied: before, during and after 3-6 months of occlusal splint therapy. The fluctuating signs and symptoms, as well as the postural activity of the temporal and masseter muscles were significantly reduced after treatment. Further, the coefficients of correlation within pairs of postural activity of the right and left muscles increased significantly. After cessation of the splint therapy the signs and symptoms recurred to the pre-treatment level within 1-4 weeks in about 80% of the patients. The results indicate that an occlusal splint can eliminate or diminish signs and symptoms of functional disorders and re-establish symmetric and reduced postural activity in the temporal and masseter muscles, which can facilitate procedures, such as functional analysis and occlusal adjustment.

Adolescent↗

Effect of topical cheek surface anesthesia on isometric contractions of the human masseter muscle.

To study the possibility of interactions between buccal cutaneous sensory receptors and voluntary maximum isometric contractions of the masseter muscles, six adult subjects exercised maximum teeth clenching before and after spraying the right cheek surface with aerosol containing 20% benzocaine. The right cheek and masseter muscle served as the experimental side, the left cheek and masseter muscle as the control side. Isometric motor outputs, on the right and left sides, were monitored by integrated surface electromyography over periods of 10 seconds. Topical surface anesthesia provided no evidence of motor modulation by cutaneous tactile receptors. Before and after anesthesia, the two muscles showed nearly identical and well-coordinated motor innervation patterns. It is suggested that the cortical motor commands of maximum isometric contractions, with recruitment of practically all available motor units, overrule all modulatory inputs except those of fatigue.

Adult↗

Contractile activity of the masseter muscle in experimental clenching and grinding of the teeth in man.

Six human subjects exercised maximum voluntary tooth clenching and right-sided tooth grinding to determine the onset of fatigue in the right and left masseter muscle. Static and dynamic contractile activity of the two muscles was determined by surface electromyography. Muscle fatigue appeared after about 30 s of isometric contractions (clenching), while 30 s of combined concentric and eccentric contractions (grinding) induced no fatigue. In the right muscle the contractile activity of negative work (eccentric contractions of mandibular laterotrusion) was about 50% of that of positive work (concentric contractions of mandibular mediotrusion). During clenching an increased number of contacting teeth might have facilitated the contractile activity of the two muscles. During grinding the height of the cusps of the working side teeth might have contributed to a decrease of tension production by the right masseter muscle. Non-working side tooth contacts and peripheral receptors might have facilitated the contractile activity of the left masseter muscle during tooth grinding. Static contractile activity of the mandibular elevator muscles produced high levels of isometric tension and led to masseter muscle fatigue in about 30 s. The same duration of dynamic contractile activity, resulting in low levels of tension during positive and negative work, did not induce fatigue.

Adult↗