A cadaveric analysis of the efficacy of blind injections into the lateral pterygoid muscle.

Autor:	Durfee A; Discipline of Anatomy, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland., Finnegan E; Discipline of Anatomy, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland., Lewis C; Discipline of Anatomy, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland., Franklin C; Discipline of Anatomy, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland., Varsou O; Anatomy Facility, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom., Barry D; Discipline of Anatomy, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland. debarry@tcd.ie.
Jazyk:	angličtina
Zdroj:	Folia morphologica [Folia Morphol (Warsz)] 2024 Dec 15. Date of Electronic Publication: 2024 Dec 15.
DOI:	10.5603/fm.102905
Abstrakt:	Background: Temporomandibular disorders (TMD) are amongst the most common causes of orofacial pain. Hyperactivity of the lateral pterygoid muscle (LPM) is associated with the pathological mechanisms associated with TMD. Botulinum Toxin-A (BTX) injections into the LPM can be used as a treatment for TMD; however, a lack of clinical standardisation for this procedure can lead to adverse outcomes, especially when using anatomical landmark-based approaches. Materials and Methods: To better understand the precision of extraoral landmark-based LPM BTX injections, a maxillofacial surgeon injected 1.5 mL of 0.25% methylene blue dye into the LPM of five cadavers. Needle location, dye spread, and disrupted structures were then examined through cadaveric dissection. Results: Landmark-based LPM BTX approaches resulted in poor outcomes in accuracy (0%) and a 40% incidence of neurovascular disruption, including the facial plexus, superficial temporal artery and superficial temporal vein. Conclusions: Randomised controlled trials have highlighted the risks associated with extraoral botulinum toxin injections for TMD symptomatic relief. This report demonstrates the low accuracy rate and high neurovascular risk accompanying blind LPM injections and highlights the necessity of safe treatment protocols in TMD, in particular guided image-based diagnostics and procedures.
Databáze:	MEDLINE
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