title: Mandibular angle resection and masticatory muscle hypertrophy - a technical note and morphological optimization.
abstract: BACKGROUND
  Mandibular angle resection is rarely used, but is a highly effective means of correcting facial defects. We report a mandibular angle resection technique associated with the removal of a part of hypertrophic masseter muscles and resection of buccal fat pad.
  
  
  METHODS
  Anatomical reminders: the most important entities are the facial artery and vein, crossing the lower margin of the jaw just in front of the anterior boarder of the masseter muscle and the temporomaxillary vein, passing through the temporomaxillary fossa; preoperative aspects: the preoperative examination included a radiological assessment of the shape and size of the mandibular angle; surgical technique: an intra-oral approach was usually used. The most effective and convenient method for the osteotomy was using a reciprocating saw. This technique allowed achieving a smooth contour of masseter muscles during masticatory movements or at rest.
  Eleven mandibular angle resections were performed from 2001 to 2009. The surgery was supplemented by remodeling the lower margin of the jaw for 5 other patients. No permanent facial palsy was noted. One patient presented a unilateral long-term loss of sensitivity of the lower lip and chin.
  
  
  CONCLUSIONS
  This surgical technique if simple even requires using good technical equipment, and observing a set of rules. Using these principles allows simplifying the surgical technique, and decreasing its morbidity. A part of the masseter muscles and the buccal fat pad can sometimes be resected to improve the morphological results.
authors.affiliation: Department of Oral and Maxillofacial Surgery - St. Petersburg Pavlov State Medical University, Savushkina srt., 8/2, St., Petersburg, 197341, Russia.
authors.forename: A R
authors.initials: AR
authors.lastname: Andreishchev
authors.affiliation: Oral and Maxillofacial Surgery Department, Lille 2 University, hôpital Roger-Salengro, boulevard du Professeur-Emile-Laine, 59037 Lille cedex, France. Electronic address: romain.nicot@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Nicot
authors.affiliation: Oral and Maxillofacial Surgery Department, Lille 2 University, hôpital Roger-Salengro, boulevard du Professeur-Emile-Laine, 59037 Lille cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Ferri
mesh_terms: D000273:Adipose Tissue / Q000473:pathology / Q000601:surgery; D006801:Humans; D006984:Hypertrophy / Q000453:epidemiology / Q000601:surgery*; D008310:Malocclusion / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008406:Masseter Muscle / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D009061:Mouth Mucosa / Q000473:pathology / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D057234:Preoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies
keywords: Hypertrophie du muscle masséter; Masseter muscle hypertrophy; Oral surgical procedures; Osteotomy; Ostéotomie; Technique de chirurgie orale