These findings suggest that treatment of muscle spasticity of the ankle invertors involves botulinum toxin injections in specific areas. These areas, corresponding to the areas of maximum arborization, are recommended as the most effective and safest points for injection.
The aim of this study was to elucidate the distribution of the accessory nerve within the sternocleidomastoid muscle (SCM) to aid identifying the optimum sites for botulinum neurotoxin (BoNT) injections and applying chemical neurolysis. Thirty SCM specimens from 15 Korean cadavers were used in this study. Sihler's staining was applied to 10 of the SCM specimens. Transverse lines were drawn in 20 sections to divide the SCM into 10 divisions vertically, and a vertical line was drawn into the medial and lateral halves from the mastoid process to the sternoclavicular joint. The most densely innervated areas were 5/10-6/10 and 6/10-7/10 along the lateral and medial parts of the muscle, respectively. We suggest injecting BoNT in the medial region 6/10-7/10 along the SCM prior to injecting in the lateral region 5/10-6/10 along the muscle to ensure safe and effective treatment. Clin. Anat. 33:192-198, 2020.
Based on the results of this study, clinicians can increase the effectiveness of therapeutic functional electrical stimulation and identify the ideal sites for botulinum toxin injection to the tibialis anterior muscle.
Background
Temple filler injection is one of the most common minimally invasive cosmetic procedures involving the face; however, vascular complications are not uncommon.
Objectives
This study aimed to investigate the anatomy of the temporal vessels and provide a more accurate protocol for temple filler injection.
Methods
Computed tomography (CT) scans of 56 cadaveric heads injected with lead oxide were obtained. We then used Mimics software to construct 3-dimensional (3D) images of the temporal vessels described by a coordinate system based on the bilateral tragus and right lateral canthus.
Results
In the XOY plane, the superficial temporal artery (STA), middle temporal artery (MTA), zygomatico-orbital artery (ZOA), posterior branch of the deep temporal artery (PDTA), and lateral margin of the orbital rim divide the temple into 4 parts (A, B, C, and D). The probabilities of the STA, MTA, ZOA, and PDTA appearing in parts A, B, C, and D were 30.73%, 37.06%, 39.48%, and 77.18%, respectively. In 3D images, these vessels together compose an arterial network that is anastomosed with other vessels, such as the external carotid, facial, and ocular arteries.
Conclusions
3D CT images can digitally elucidate the exact positions of temporal vessels in a coordinate system, improving the safety of temple filler injections in a clinical setting.
ince Furnas 1 first described the retaining ligaments of the cheek in 1989, numerous studies have focused on further clarifying their anatomy and how they might be used in facial rejuvenation. [2][3][4][5][6][7][8] The ligamentous structures of the face play an important role in restricting facial mobility in different anatomical regions, dictating the ways tissues yield in response to gravity, and creating boundaries between their fixation points. 9 The achievement of consistently reproducible facial rejuvenation procedures requires even greater comprehension of the ligamentous anatomical structures contained in the facial framework. 6 It is now widely recognized that in rejuvenation surgery, specific anatomical attachments (i.e., ligaments, septa, and adhesions) to the periosteum and deep fascia must be defined and released to allow unrestricted mobilization and redraping of the soft tissues. [10][11][12] In the anteromedial midface, adequate mobilization of the soft tissues requires a specific attachment, the zygomatic cutaneous ligament, to be released from the periosteum, as a number of authors have confirmed through their surgical observations. 3,10,13 Although the presence of this robust attachment to the zygoma
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