A 15-year-old female patient presenting with no painless right facial manifestation in a painless form is presented at the Maxillofacial Surgery Service of the Complejo Hospitalario San Borja Arriarán.
In the interview, the patient did not report morbid or surgical history.
Neither does he mention the use of any drug in the usual way nor allergies.
No type of parafunction is investigated.
Extraoral examination showed an increase in volume in the right mandibular angle region with poorly defined limits.
The fixation is firm, painless and has no inflammatory signs or submandibular or cervical lymph node involvement.
TMJ examination revealed no pathological signs or symptoms.
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The intraoral examination does not show anything relevant in relation to soft tissues, teeth and occlusion.
Salivary secretion was normal, especially in relation to Stenon's ducts.
A panoramic radiograph was requested, as well as a marked right mandibular angle.
Double mandibular contour was observed in the lateral skull radiograph and in the frontal telegraphy it was observed that the right mandibular sector presents a greater development, not affecting the occlusal plane.
Bone scintigraphy was also performed to rule out condylar hyperplasia and electromyography.
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The diagnosis was unilateral right masseteric hypertrophy, so the resection of the right mandibular angle was decided by extraoral approach.
Under general anesthesia, a right sub-angle-mandibular approach is performed until the ipsilateral angle is exposed.
Resection of this angle and a portion of the masseter muscle was performed.
A biopsy of the extracted muscle was performed, whose report did not reveal any pathological condition of the tissues.
The patient was monitored immediately after the intervention without complications.
In the control performed after 6 years, the patient is in good condition without recurrence.
