title: Recurrent parotid swelling secondary to masseter muscle hypertrophy: a multidisciplinary diagnostic and therapeutic approach.
abstract: OBJECTIVE
  To present a patient with an atypical recurrent parotid swelling due to masseter muscle hypertrophy and the diagnostic/therapeutic assessment to treat this condition.
  
  
  METHODS
  A patient referring recurrent right facial swelling underwent a complete multidisciplinary assessment of the parotid region that revealed masseter muscle hypertrophy, confirmed by means of clinical (otolaryngological and gnathological evaluation), radiological (utrasonography, dynamic magnetic resonance imaging, and cone beam computed tomography), instrumental (electromyography to evaluate the right masseter muscle function and kinesiography to evaluate maximum right deflection - MaxRDefl and maximum opening - MaxMO) and sialendoscopy assessment where T0 indicates the pre-treatment values. All electromyographic and kinesiographic parameters were evaluated six months after the orthodontic application of a neuromuscular orthosis at T1. At T1, the effectiveness of the orthodontic therapy was demonstrated by the complete resolution of symptoms, and instrumental results documented more efficient muscle activity at rest and during clenching and a better mandibular position. At EMG T1, the resting and post-TENS values were, respectively, 1.2 and 1.8 microV. At kinesiography, MaxRDefl increased from 10.2 (T0) to 10.5 mm (T1); maxMO increased from 41.2 (T0) to 48 mm (T1).
  
  
  CONCLUSIONS
  The proposed multidisciplinary assessment based on otolaryngological, gnathological, and radiological evaluation may be useful in the case of recurrent parotid swelling secondary to masseter muscle hypertrophy to plan an appropriate management with a removable neuromuscular orthosis.
authors.affiliation: a Department of Otolaryngology and Head and Neck Surgery , Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico , Milan , Italy.|c Department of Biomedical, Surgical and Dental Sciences , Università degli Studi di Milano , Milan , Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Capaccio
authors.affiliation: a Department of Otolaryngology and Head and Neck Surgery , Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico , Milan , Italy.|d Department of Clinical Sciences and Community Health , Università degli Studi di Milano , Milan , Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Gaffuri
authors.affiliation: a Department of Otolaryngology and Head and Neck Surgery , Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico , Milan , Italy.|d Department of Clinical Sciences and Community Health , Università degli Studi di Milano , Milan , Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pignataro
authors.affiliation: b Department of Maxillofacial Surgery and Odontostomatology , Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico , Milan , Italy.|c Department of Biomedical, Surgical and Dental Sciences , Università degli Studi di Milano , Milan , Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Assandri
authors.affiliation: b Department of Maxillofacial Surgery and Odontostomatology , Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico , Milan , Italy.|c Department of Biomedical, Surgical and Dental Sciences , Università degli Studi di Milano , Milan , Italy.
authors.forename: Pollyanna
authors.initials: P
authors.lastname: Pereira
authors.affiliation: b Department of Maxillofacial Surgery and Odontostomatology , Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico , Milan , Italy.|c Department of Biomedical, Surgical and Dental Sciences , Università degli Studi di Milano , Milan , Italy.
authors.forename: Giampietro
authors.initials: G
authors.lastname: Farronato
mesh_terms: D002012:Bruxism / Q000150:complications / Q000628:therapy; D004487:Edema / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004576:Electromyography; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D019028:Magnetic Resonance Imaging, Cine; D008406:Masseter Muscle / Q000002:abnormalities*; D008875:Middle Aged; D009968:Orthodontic Appliances, Removable; D010305:Parotid Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012008:Recurrence; D012796:Sialography
keywords: Electromyography; Kinesiography; Masseter hypertrophy; Masticatory muscles; Parotid gland; Recurrent parotitis; Salivary glands; Sialendoscopy