A 34-YEAR-OLD woman sought an otorhinolaryngological opinion about the shape of her lower jaw. She had been aware for some years that her face had subtly changed in shape but sought medical advice only after a friend remarked on it. Her eyes and mouth were not dry. She was an anxious person and had a history of bruxism.
Physical examination showed a woman with a square-shaped face due to bilateral swelling at the angles of the mandible. The swellings, which were fixed and nontender, showed lipping at the inferior border of the body of the mandible and increased in size when the patient clenched her teeth. The findings of intraoral examination were not helpful in making a diagnosis.