Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 822-828 |
| Number of pages | 7 |
| Journal | Clinical Anatomy |
| Volume | 34 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2021 Sept |
Bibliographical note
Funding Information:The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge that can then improve patient care. Therefore, these donors and their families deserve our highest gratitude. We thank all the donors of the cadavers. None of the authors claim financial support from commercial, academic, or political organizations or people regarding this study. The authors thank Eun‐Byul Yi from Eonbuk Elementary School for Illustrations. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean Government (MSIP) (NRF‐2020R1A2B5B0100223811).
Funding Information:
The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge that can then improve patient care. Therefore, these donors and their families deserve our highest gratitude. We thank all the donors of the cadavers. None of the authors claim financial support from commercial, academic, or political organizations or people regarding this study. The authors thank Eun-Byul Yi from Eonbuk Elementary School for Illustrations. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean Government (MSIP) (NRF-2020R1A2B5B0100223811).
Publisher Copyright:
© 2020 American Association of Clinical Anatomists
All Science Journal Classification (ASJC) codes
- Anatomy
- Histology