Jung-Hee Bae1, Ji-Soo Lee2, Da-Yae Choi3, JeongHoon Suhk4, Seong Taek Kim5. 1. Division of Health Science, Department of Dental Hygiene, Dongseo University, Busan, South Korea. 2. Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul, South Korea. 3. Department of Dental Hygiene, Baekseok University, Cheonan, South Korea. 4. Chungdam i Plastic Surgery Clinic, Uijeongbu, South Korea. 5. Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul, South Korea. k8756050@yuhs.ac.
Abstract
PURPOSE: The descending part of the trapezius muscle is clinically associated with neck pain and aesthetic applications. The innervation of the trapezius muscle is not well described in the medical literature for clinicians. The aim of study was to analyze the perforating branch pattern of the accessory nerve in the descending part of the trapezius muscle with the aim of describing the most efficient and reproducible BoNT injection sites for aesthetic treatment of shoulder contouring. METHODS: Twenty-six specimens (five male and eight female) from embalmed Korean cadavers were used in this study. The trapezius muscle was dissected scrupulously and then reflected to enable examination of the locations of the perforating points. The thickness of trapezius muscle was measured in 13 volunteers using a diagnostic ultrasonography system. BoNT was injected into the trapezius muscle bilaterally. Injections were performed at 6 points separated by 2 cm. The muscle thicknesses were measured three times using ultrasonography: before the injection and at 4 and 12 weeks after the injection. RESULTS: The dense arborization of the perforating accessory nerve branches was confined mostly to section b (66.7%, 54/81) and section c (33.3%, 27/81). The mean muscle thickness at 4 and 12 weeks consistently decreased 0.68-0.63 cm in conventional method and 0.65-0.61 cm in new method (NDM) respectively (right and left). CONCLUSION: To optimize the outcome of BoNT injection, we recommended injecting into six points separated by 2 cm in sections b and c of the upper trapezius muscle. It is significant that it is easier to apply to anyone than to apply unstructured techniques.
PURPOSE: The descending part of the trapezius muscle is clinically associated with neck pain and aesthetic applications. The innervation of the trapezius muscle is not well described in the medical literature for clinicians. The aim of study was to analyze the perforating branch pattern of the accessory nerve in the descending part of the trapezius muscle with the aim of describing the most efficient and reproducible BoNT injection sites for aesthetic treatment of shoulder contouring. METHODS: Twenty-six specimens (five male and eight female) from embalmed Korean cadavers were used in this study. The trapezius muscle was dissected scrupulously and then reflected to enable examination of the locations of the perforating points. The thickness of trapezius muscle was measured in 13 volunteers using a diagnostic ultrasonography system. BoNT was injected into the trapezius muscle bilaterally. Injections were performed at 6 points separated by 2 cm. The muscle thicknesses were measured three times using ultrasonography: before the injection and at 4 and 12 weeks after the injection. RESULTS: The dense arborization of the perforating accessory nerve branches was confined mostly to section b (66.7%, 54/81) and section c (33.3%, 27/81). The mean muscle thickness at 4 and 12 weeks consistently decreased 0.68-0.63 cm in conventional method and 0.65-0.61 cm in new method (NDM) respectively (right and left). CONCLUSION: To optimize the outcome of BoNT injection, we recommended injecting into six points separated by 2 cm in sections b and c of the upper trapezius muscle. It is significant that it is easier to apply to anyone than to apply unstructured techniques.
Entities:
Keywords:
Accessory nerve; Botulinum toxin; Injection point; The descending part of trapezius
Authors: R Shane Tubbs; Mohammadali M Shoja; Marios Loukas; Jeffrey Lancaster; Martin M Mortazavi; Eyas M Hattab; Aaron A Cohen-Gadol Journal: J Neurosurg Spine Date: 2011-02-25
Authors: Clara Svenberg Lind; Bertil Lundberg; Lalle Hammarstedt Nordenvall; Susanne Heiwe; Jonas K E Persson; Jonas Hydman Journal: Ann Otol Rhinol Laryngol Date: 2015-06-01 Impact factor: 1.547