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Effective Botulinum Toxin Injection Guide for Treatment of Temporal Headache

View Article: PubMed Central - PubMed

ABSTRACT

This study involved an extensive analysis of published research on the morphology of the temporalis muscle in order to provide an anatomical guideline on how to distinguish the temporalis muscle and temporalis tendon by observing the surface of the patient’s face. Twenty-one hemifaces of cadavers were used in this study. The temporalis muscles were dissected clearly for morphological analysis between the temporalis muscle and tendon. The posterior border of the temporalis tendon was classified into three types: in Type I the posterior border of the temporalis tendon is located in front of reference line L2 (4.8%, 1/21), in Type II it is located between reference lines L2 and L3 (85.7%, 18/21), and in Type III it is located between reference lines L3 and L4 (9.5%, 2/21). The vertical distances between the horizontal line passing through the jugale (LH) and the temporalis tendon along each of reference lines L0, L1, L2, L3, and L4 were 29.7 ± 6.8 mm, 45.0 ± 8.8 mm, 37.7 ± 11.1 mm, 42.5 ± 7.5 mm, and 32.1 ± 0.4 mm, respectively. BoNT-A should be injected into the temporalis muscle at least 45 mm vertically above the zygomatic arch. This will ensure that the muscle region is targeted and so produce the greatest clinical effect with the minimum concentration of BoNT-A.

No MeSH data available.


Reference points and lines based on surface anatomical structures. Jugale: A landmark on the skull at which the temporal and frontal processes of the zygomatic bone meet. LH: The horizontal line passing through the jugale. L0: The vertical line passing through the jugale. L1: The line evenly dividing L0 and L2. L2: The vertical line passing through the anterior outer margin of the ear. L3: The line evenly dividing L2 and L4. L4: The vertical line passing through the posterior outer margin of the ear.
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toxins-08-00265-f001: Reference points and lines based on surface anatomical structures. Jugale: A landmark on the skull at which the temporal and frontal processes of the zygomatic bone meet. LH: The horizontal line passing through the jugale. L0: The vertical line passing through the jugale. L1: The line evenly dividing L0 and L2. L2: The vertical line passing through the anterior outer margin of the ear. L3: The line evenly dividing L2 and L4. L4: The vertical line passing through the posterior outer margin of the ear.

Mentions: The ear and reference lines L2, L3, and L4 was used to clearly delineate the temporalis tendon. Details on reference line used in this study are on Figure 1. The posterior border where the temporalis tendon disperses can be classified into the following three types:


Effective Botulinum Toxin Injection Guide for Treatment of Temporal Headache
Reference points and lines based on surface anatomical structures. Jugale: A landmark on the skull at which the temporal and frontal processes of the zygomatic bone meet. LH: The horizontal line passing through the jugale. L0: The vertical line passing through the jugale. L1: The line evenly dividing L0 and L2. L2: The vertical line passing through the anterior outer margin of the ear. L3: The line evenly dividing L2 and L4. L4: The vertical line passing through the posterior outer margin of the ear.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037491&req=5

toxins-08-00265-f001: Reference points and lines based on surface anatomical structures. Jugale: A landmark on the skull at which the temporal and frontal processes of the zygomatic bone meet. LH: The horizontal line passing through the jugale. L0: The vertical line passing through the jugale. L1: The line evenly dividing L0 and L2. L2: The vertical line passing through the anterior outer margin of the ear. L3: The line evenly dividing L2 and L4. L4: The vertical line passing through the posterior outer margin of the ear.
Mentions: The ear and reference lines L2, L3, and L4 was used to clearly delineate the temporalis tendon. Details on reference line used in this study are on Figure 1. The posterior border where the temporalis tendon disperses can be classified into the following three types:

View Article: PubMed Central - PubMed

ABSTRACT

This study involved an extensive analysis of published research on the morphology of the temporalis muscle in order to provide an anatomical guideline on how to distinguish the temporalis muscle and temporalis tendon by observing the surface of the patient’s face. Twenty-one hemifaces of cadavers were used in this study. The temporalis muscles were dissected clearly for morphological analysis between the temporalis muscle and tendon. The posterior border of the temporalis tendon was classified into three types: in Type I the posterior border of the temporalis tendon is located in front of reference line L2 (4.8%, 1/21), in Type II it is located between reference lines L2 and L3 (85.7%, 18/21), and in Type III it is located between reference lines L3 and L4 (9.5%, 2/21). The vertical distances between the horizontal line passing through the jugale (LH) and the temporalis tendon along each of reference lines L0, L1, L2, L3, and L4 were 29.7 ± 6.8 mm, 45.0 ± 8.8 mm, 37.7 ± 11.1 mm, 42.5 ± 7.5 mm, and 32.1 ± 0.4 mm, respectively. BoNT-A should be injected into the temporalis muscle at least 45 mm vertically above the zygomatic arch. This will ensure that the muscle region is targeted and so produce the greatest clinical effect with the minimum concentration of BoNT-A.

No MeSH data available.