Wee Sung Jae, Park Myong Chul, Chung Chan Min, Tak Seung Wan
Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
TN Plastic and Reconstructive Surgery Clinic, Seoul, Korea.
Arch Craniofac Surg. 2021 Apr;22(2):115-118. doi: 10.7181/acfs.2021.00087. Epub 2021 Apr 20.
Intramuscular hemangioma is a rare vascular benign proliferation that can occur within any muscle, particularly in the trunk and extremities. In the head and neck region, the masseter muscle is most commonly involved, followed by the periorbital and sternocleidomastoid muscles. Diagnosing intramuscular hemangioma is challenging because there are no characteristic symptoms; instead, magnetic resonance imaging is the best imaging modality to diagnose these lesions. Complete surgical resection is the treatment of choice, although the local recurrence rate is high. Herein, we report a rare case of intramuscular hemangioma located in the zygomaticus minor muscle, which is related to smiling and usually runs along the orbicularis oculi muscle. Distinguishing or separating these two muscles is challenging. However, based on the muscle vector of the midface and radiological findings, the two muscles were successfully separated. The zygomaticus minor was cut very slightly to approach to the lesion and the muscle fibers were split to excise it. A follow-up examination revealed no nerve damage or muscle dysfunction at 4 weeks postoperatively. This rare case may serve as a reference for managing intramuscular hemangioma in the head and neck region.
肌内血管瘤是一种罕见的血管良性增生，可发生于任何肌肉内，尤其是躯干和四肢的肌肉。在头颈部区域，最常累及咬肌，其次是眶周肌和胸锁乳突肌。由于没有特征性症状，诊断肌内血管瘤具有挑战性；相反，磁共振成像（MRI）是诊断这些病变的最佳影像学检查方法。尽管局部复发率较高，但完整手术切除仍是首选治疗方法。在此，我们报告一例罕见的位于颧小肌的肌内血管瘤病例，该血管瘤与微笑有关，通常沿眼轮匝肌走行。区分或分离这两块肌肉具有挑战性。然而，根据中面部的肌肉向量和影像学检查结果，成功分离了这两块肌肉。对颧小肌进行了非常轻微的切断以接近病变，并劈开肌纤维将其切除。术后4周的随访检查显示无神经损伤或肌肉功能障碍。这个罕见病例可为头颈部区域肌内血管瘤的治疗提供参考。
