期刊
CLINICAL ANATOMY
卷 34, 期 6, 页码 822-828出版社
WILEY
DOI: 10.1002/ca.23690
关键词
botulinum neurotoxin; cervical dystonia; clinical guideline; cosmetic shoulder; shoulder contour; trapezius muscle
资金
- National Research Foundation of Korea (NRF)
- Korean Government (MSIP) [NRF-2020R1A2B5B0100223811]
This study proposed an ideal injection point for botulinum toxin in the trapezius muscle, based on the intramuscular nerve branching patterns. The study suggests specific regions within the trapezius muscle for BoNT treatments to maximize efficacy and minimize adverse effects.
Introduction This study proposes an ideal botulinum toxin injection point of the trapezius muscle for shoulder line contouring, pain management, and functional impairment. This study describes the intramuscular nerve branching in the trapezius muscle, providing essential information for botulinum neurotoxin injection. Method A modified Sihler's method was performed on the trapezius muscles (16 specimens). The intramuscular arborization areas were elucidated regarding the external occipital protuberance superiorly, spinous process of the 12th thoracic vertebra inferiorly and acromion of the scapula. Result The intramuscular neural distribution for the superior, middle, and inferior regions of the trapezius muscle had the greatest arborized patterns in the horizontal 1/5-2/5 and vertical 2/10-4/10 sections, the horizontal 1/5-3/5 and vertical 4/10-5/10 sections, and the horizontal 1/5-2/5 and vertical 5/10-7/10 sections, respectively. Discussion We propose that BoNT treatments should be directed to the horizontal 1/5-2/5 and vertical 2/10-4/10 sections of the superior trapezius, the horizontal 1/5-3/5 and vertical 4/10-5/10 sections of the middle trapezius and the horizontal 1/5-2/5 and vertical 5/10-7/10 sections of the inferior trapezius. Additionally, injective treatment at the horizontal 2/5-3/5 and vertical 2/10-4/10 nerve entry points should be avoided to prevent nerve trunk damage causing paralysis. According to our guidelines, clinicians can ensure minimal dose injections and fewer adverse effects in botulinum neurotoxin injective treatment.
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