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Toxins 2016, 8(9), 265;

Effective Botulinum Toxin Injection Guide for Treatment of Temporal Headache

Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul 03722, South Korea
Author to whom correspondence should be addressed.
Academic Editor: Bahman Jabbari
Received: 29 July 2016 / Revised: 31 August 2016 / Accepted: 5 September 2016 / Published: 8 September 2016
(This article belongs to the Collection Botulinum Toxins on Human Pain)
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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. View Full-Text
Keywords: migraine; botulinum toxin type A; temporalis muscle; injection site; Sihler staining migraine; botulinum toxin type A; temporalis muscle; injection site; Sihler staining

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Choi, Y.-J.; Lee, W.-J.; Lee, H.-J.; Lee, K.-W.; Kim, H.-J.; Hu, K.-S. Effective Botulinum Toxin Injection Guide for Treatment of Temporal Headache. Toxins 2016, 8, 265.

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