Intramuscular nerve distribution of the sternocleidomastoid muscle for the botulinum toxin injection
Makaleler > Tam Makale · 2024
Yazarlar: Melisa GÜLCAN, Servet ÇELİK, Okan BİLGE, Canberk Tomruk, Yiğit UYANIKGİL
SURGICAL AND RADIOLOGIC ANATOMY, SCI Expanded İndekslerine Giren Dergi, Uluslararası, 2024, ss 1-10
DOI: 10.1007/s00276-024-03367-0
Özet
<p>Purpose The aim of this study is to define the intramuscular nerve distribution of the sternocleidomastoid muscle (SCM) and </p><p>the innervation zones (IZ) to describe the optimal botulinum toxin injection sites.</p><p>Methods The cricoid cartilage (CC), laryngeal prominence (LP) and hyoid bone (HB) and angle of mandible (AM) were </p><p>determined as landmarks. The length of the muscles were measured between the sternoclavicular joint and tip of the mastoid </p><p>process. SCM was evaluated in two parts as anterior and posterior divided by the line where the length of the muscle was </p><p>measured. Measurements were made to define the relationships of the SCM with common carotid artery, internal and exter-</p><p>nal jugular veins. IZ were described according to these vessels. Afterwards, Modified Sihler’s staining technique was applied </p><p>to expose the intramuscular nerve distribution.</p><p>Results The average length of SCM was 160,1 mm. Motor entry point of the accessory nerve fibers were between the </p><p>AM-HB lines, in the range of 30–40% of the muscle length, and in the posterior part of the muscles. IZ were between the </p><p>HB-CC lines in the anterior and posterior part. When this interval was examined according to the vessels, the optimal injec-</p><p>tion sites were between the LP-CC lines.</p><p>Conclusions This study shows the position of the intramuscular nerve fibers endings of the SCM according to the chosen </p><p>landmarks and the relationship of the IZ with the vessels to prevent complications. These results can be used as a guide for </p><p>safe and effective botulinum toxin injections with optimal quantities.</p>