Abstract：
Paradoxical masseteric bulging refers to an unexpected occurrence of masseter muscle bulging or protrusion following the administration of botulinum toxin injections, contrary to the anticipated muscle weakening effect. It may occur secondary to toxin failing to diffuse through the entire masseter muscle due to the presence of an inferior tendon structure within the superficial masseter that divides it into a superficial and deep belly. We report a clinical case of paradoxical masseteric bulging in a female in her late 40s who developed this adverse effect within a week of her masseter botulinum neurotoxin type A injections. We also describe the masseter two-site injection technique for the management of this complication.
摘要：
矛盾的咬肌膨出是指在注射肉毒杆菌毒素后意外发生咬肌膨出或突出，与预期的肌肉弱化效果相反。由于浅表咬肌内部存在下腱结构，将其分为浅表和深腹部，因此毒素无法通过整个咬肌扩散。我们报告了一例40多岁的女性矛盾的咬肌膨出的临床病例，该女性在注射A型咬肌神经毒素后一周内出现了这种不良反应。我们还描述了用于治疗这种并发症的咬肌两部位注射技术。
