The temporal muscles are fan-shaped muscles on the sides of your head that extend from the temples. Their primary function is to help close the jaw for chewing. Temporal muscle wasting, or atrophy, is the shrinking of these muscles. This loss of muscle mass creates a hollowed or sunken look in the temple region and is often a sign of an underlying health issue.
Identifying Temporal Muscle Wasting
The most apparent sign of temporal muscle wasting is a visible depression or hollowing on the sides of the head. This change can make the zygomatic arches, or cheekbones, appear more prominent and may give the head a “peanut” shape when severe. The wasting can occur on one side (unilateral) or both sides (bilateral) of the head.
Beyond the visible signs, temporal muscle wasting can present functional symptoms. Individuals may experience weakness or fatigue in the jaw, particularly when chewing tougher foods. This can sometimes be accompanied by pain in the temporal region or headaches. Difficulty in fully opening the mouth or a feeling of jaw stiffness can also be associated with the condition.
Underlying Causes
The reasons for temporal muscle wasting are varied, often pointing to systemic health issues. A common cause is the natural aging process, where sarcopenia, the age-related decline in muscle mass and strength, affects muscles throughout the body, including the temporalis. The severity of this gradual loss can differ between individuals.
Nutritional deficiencies are a significant contributor to muscle atrophy. Conditions that lead to significant weight loss, malnutrition, or a state of severe metabolic stress called cachexia can cause the body to break down muscle tissue for energy. Cachexia is frequently seen in patients with advanced cancer, chronic kidney disease, or congestive heart failure, and the temporal muscles are often one of the first places these effects become visible.
Neurological conditions that affect the nerves controlling the jaw muscles can also lead to temporal wasting. The temporal muscle is innervated by the trigeminal nerve, and any damage to this nerve from a stroke, motor neuron disease, or physical trauma can interrupt the signals required to maintain muscle health, causing it to shrink.
Issues related to the jaw and teeth can cause what is known as disuse atrophy. Conditions like severe temporomandibular joint (TMJ) disorder or significant dental problems can make chewing painful or difficult. When the temporal muscle is not used regularly for mastication, it begins to weaken and decrease in size from lack of activity.
The Diagnostic Process
Diagnosing the reason for temporal muscle wasting begins with a thorough evaluation by a healthcare provider, including a physical examination and a detailed medical history. A clinician will inspect the temporal areas, assess jaw function, and ask about symptoms, dietary habits, recent weight changes, and overall health.
To investigate potential underlying causes, a series of tests may be ordered. Blood tests are commonly used to check for markers of inflammation, nutritional deficiencies like low albumin, or signs of systemic diseases. These tests can help identify conditions such as chronic infections or autoimmune disorders that might be contributing to muscle loss.
For a more detailed view of the muscle and surrounding structures, imaging scans are often employed. An MRI or CT scan can provide clear images of the temporal muscle, allowing doctors to see the extent of the atrophy and look for abnormalities like fatty degeneration, inflammation, or damage to the nerves and bones in the area. In some cases, electromyography (EMG), a test that measures the electrical activity of muscles, may be used to assess nerve function and confirm if the wasting is due to a neurological issue.
Management and Treatment Approaches
The primary strategy for managing temporal muscle wasting is to address its root cause. For instance, if malnutrition is the cause, a dietitian may develop a plan with nutritional supplements to help reverse the muscle loss. If a TMJ disorder is responsible, treatments might include physical therapy, dental appliances, or pain management to restore proper jaw function.
Supportive therapies can play a part in managing the symptoms associated with temporal muscle wasting. Physical therapy exercises may be recommended to help improve jaw strength and maintain function, especially in cases of disuse atrophy or after a neurological injury. These exercises are designed to gently work the muscle and encourage recovery or prevent further decline.
When the muscle wasting is irreversible or if the cosmetic change is a significant concern for the individual, there are options to restore volume to the temples. Cosmetic procedures, such as the injection of dermal fillers like Voluma or Sculptra, can be used to fill in the hollowed areas. In other situations, surgical options like repositioning the damaged muscle or placing a custom implant may be considered to reconstruct the area’s natural contour.