PMC7498842_01
Extraoral photograph at first visit. Right lateral view (A), frontal view (B) and right lateral view (C) show asymmetry. Invagination was shown under the zygomatic bone.
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His extraoral findings showed facial asymmetry (Fig. 1A-C), and invagination under the zygomatic bone was recognized (Fig. 1A and B).
Panoramic X-ray at first visit.. The right mandibular condyle situated anterior gliding, whereas the left mandibular condyle was contained in the mandibular fossa.
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Panoramic X-ray showed the right mandibular condyle situated anterior gliding, whereas the left mandibular condyle was contained in the mandibular fossa (Fig. 2).
Computed tomography (CT) of the maxillofacial regions showing atrophy of masticatory muscles of right side. A) Axial view at the level of mandibular condyle and coronoid process. B) Coronal view at the level of coronoid process. C) Axial view at the level of the mandibular foramen. D) Coronal view at the level anterior to the pterygoid plate. E) Axial view at the level of submandibular space. F) Coronal view at the level of the pterygoid plate. G) Axial view at the level of submental space. (H) Axial view showing bone defect site of intracranial tumor resection through right occipital/suboccipital craniotomy (arrowhead). TM, temporalis muscle; MM, masseter muscle; LPM, lateral pterygoid muscle; MPM, medial pterygoid muscle; TVP, tensor veli palatini muscle; MHM, mylohyoid muscle; ADM, anterior belly of the digastric muscle.
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TMJ examination at the first visit showed atrophy of masticatory muscles at the right-side maxillofacial region (Fig. 3A-G). The temporalis muscle (TM), masseter muscle (MM), lateral pterygoid muscle (LPM), medial pterygoid muscle (MPM) and tensor veli palatini muscle (TVP) showed atrophy or absence on the axial view at the level of the mandibular condyle and coronoid process (Fig. 3A), coronal view at the level of the coronoid process (Fig. 3B), axial view at the level of the mandibular foramen (Fig. 3C) and coronal view at the level of anterior of the pterygoid plate (Fig. 3D). The mylohyoid muscle (MHM) was atrophied on the axial view at the level of submandibular space (Fig. 3E) and the coronal view at the level of the pterygoid plate (Fig. 3F). The anterior belly of the digastric muscle (ADM) was also absent from the axial view at the level of submental space (Fig. 3G). An axial view in Fig. 3H shows the bone defect site of the intracranial tumor resection through the right occipital/suboccipital craniotomy (arrowhead).