Mandibular Myofibroma and Severe Trismus: A Complex Case and Review of Complications
Summary:. A female child was investigated for insidious onset of temporomandibular joint dysfunction and trismus in the setting of a mandibular myofibroma. Myofibromas, benign mesenchymal neoplasms composed of spindle cells, are rarely found in the oral cavity, most commonly in the mandible. These l...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-06-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004380 |
| _version_ | 1811237168910172160 |
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| author | Zain Aryanpour, BS Dino Maglic, MD Rehan Zahid, MD Fatma B. Tuncer, MD Barbu R. Gociman, MD, PhD Faizi A. Siddiqi, MD, FACS |
| author_facet | Zain Aryanpour, BS Dino Maglic, MD Rehan Zahid, MD Fatma B. Tuncer, MD Barbu R. Gociman, MD, PhD Faizi A. Siddiqi, MD, FACS |
| author_sort | Zain Aryanpour, BS |
| collection | DOAJ |
| description | Summary:. A female child was investigated for insidious onset of temporomandibular joint dysfunction and trismus in the setting of a mandibular myofibroma. Myofibromas, benign mesenchymal neoplasms composed of spindle cells, are rarely found in the oral cavity, most commonly in the mandible. These lesions are historically described as indolent with a high cure rate and minimal recurrence rates following surgical resection. The patient initially presented with concerns regarding snoring, retrognathia, and jaw ankylosis, as well as a history of trouble latching as an infant but without obvious physical deformities. Imaging revealed a large expansile lytic mass of the mandible, but no temporomandibular joint involvement; surgical biopsy evidenced myofibroma, and the lesion was resected. Over the course of disease, the lesion continued to expand, and the patient’s maximal incisal opening continued to decrease despite conservative management with jaw physiotherapy; eventually she could not open her mouth despite the absence of joint involvement. Re-exploration along with formal jaw physiotherapy was achieved and optimal jaw opening was maintained. Myofibromas are rare benign desmoid tumors that can present anywhere in the body in solitary and multicentric forms, and previously did not present significant challenges to surgical and medical management. Tumors of the mandible may present with trismus and soft tissue ankylosis, which can mimic temporomandibular joint dysfunction in the absence of joint involvement. Physical therapy, rehabilitation, and soft tissue contracture release are key to management and improving outcomes in oral cancer patients, regardless of tumor pathology. |
| first_indexed | 2024-04-12T12:21:29Z |
| format | Article |
| id | doaj.art-cb2cd52a5950488483c167ef1a6eb25f |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-12T12:21:29Z |
| publishDate | 2022-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-cb2cd52a5950488483c167ef1a6eb25f2022-12-22T03:33:18ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-06-01106e438010.1097/GOX.0000000000004380202206000-00024Mandibular Myofibroma and Severe Trismus: A Complex Case and Review of ComplicationsZain Aryanpour, BS0Dino Maglic, MD1Rehan Zahid, MD2Fatma B. Tuncer, MD3Barbu R. Gociman, MD, PhD4Faizi A. Siddiqi, MD, FACS5From the * School of Medicine, University of Alabama at Birmingham, Birmingham, Ala.† Department of Surgery, Division of Plastic Surgery, University of Utah, Salt Lake City, Utah.† Department of Surgery, Division of Plastic Surgery, University of Utah, Salt Lake City, Utah.† Department of Surgery, Division of Plastic Surgery, University of Utah, Salt Lake City, Utah.† Department of Surgery, Division of Plastic Surgery, University of Utah, Salt Lake City, Utah.† Department of Surgery, Division of Plastic Surgery, University of Utah, Salt Lake City, Utah.Summary:. A female child was investigated for insidious onset of temporomandibular joint dysfunction and trismus in the setting of a mandibular myofibroma. Myofibromas, benign mesenchymal neoplasms composed of spindle cells, are rarely found in the oral cavity, most commonly in the mandible. These lesions are historically described as indolent with a high cure rate and minimal recurrence rates following surgical resection. The patient initially presented with concerns regarding snoring, retrognathia, and jaw ankylosis, as well as a history of trouble latching as an infant but without obvious physical deformities. Imaging revealed a large expansile lytic mass of the mandible, but no temporomandibular joint involvement; surgical biopsy evidenced myofibroma, and the lesion was resected. Over the course of disease, the lesion continued to expand, and the patient’s maximal incisal opening continued to decrease despite conservative management with jaw physiotherapy; eventually she could not open her mouth despite the absence of joint involvement. Re-exploration along with formal jaw physiotherapy was achieved and optimal jaw opening was maintained. Myofibromas are rare benign desmoid tumors that can present anywhere in the body in solitary and multicentric forms, and previously did not present significant challenges to surgical and medical management. Tumors of the mandible may present with trismus and soft tissue ankylosis, which can mimic temporomandibular joint dysfunction in the absence of joint involvement. Physical therapy, rehabilitation, and soft tissue contracture release are key to management and improving outcomes in oral cancer patients, regardless of tumor pathology.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004380 |
| spellingShingle | Zain Aryanpour, BS Dino Maglic, MD Rehan Zahid, MD Fatma B. Tuncer, MD Barbu R. Gociman, MD, PhD Faizi A. Siddiqi, MD, FACS Mandibular Myofibroma and Severe Trismus: A Complex Case and Review of Complications Plastic and Reconstructive Surgery, Global Open |
| title | Mandibular Myofibroma and Severe Trismus: A Complex Case and Review of Complications |
| title_full | Mandibular Myofibroma and Severe Trismus: A Complex Case and Review of Complications |
| title_fullStr | Mandibular Myofibroma and Severe Trismus: A Complex Case and Review of Complications |
| title_full_unstemmed | Mandibular Myofibroma and Severe Trismus: A Complex Case and Review of Complications |
| title_short | Mandibular Myofibroma and Severe Trismus: A Complex Case and Review of Complications |
| title_sort | mandibular myofibroma and severe trismus a complex case and review of complications |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004380 |
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