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Intramuscular nerve distribution of the masseter muscle as a basis for botulinum toxin injection

 Da-Hye Kim  ;  Hee-Suk Hong  ;  Sung-Yoon Won  ;  Hyun-Joo Kim  ;  Kyung-Seok Hu  ;  Jong-Hoon Choi  ;  Hee-Jin Kim 
 JOURNAL OF CRANIOFACIAL SURGERY, Vol.21(2) : 588-591, 2010 
Journal Title
Issue Date
Aged ; Botulinum Toxins, Type A/administration & dosage* ; Cadaver ; Coloring Agents ; Dissection ; Female ; Humans ; Hypertrophy ; Injections, Intramuscular ; Male ; Masseter Muscle/blood supply ; Masseter Muscle/innervation* ; Masseter Muscle/pathology ; Middle Aged ; Neuromuscular Agents/administration & dosage*
Botulinum toxin ; masseter muscle ; masseteric hypertrophy ; masseteric nerve
The aim of this study was to determine intramuscular distribution pattern of the masseteric nerve, thus providing information regarding the most efficient and safe site for botulinum toxin (BTX) injection for conventional BTX intervention therapy in the treatment of masseteric hypertrophy.Twelve masseter muscles were dissected, and the pattern of innervation of the masseteric nerve was observed in the superficial, middle, and deep layers. We also analyzed 10 muscles that had been stained using Sihler's staining technique.The nerve branches from the posterosuperior and posteroinferior groups innervating the deep and middle layers of the masseter muscle, respectively. Among the nerve twigs originating from the anteroinferior nerve group, 2 or 3 perforated the superficial layer of the muscle. Observation of stained specimens revealed that all perforating branches innervating the superficial layer were mainly confined to and distributed within areas V or VI.Between 2 and 4 perforating branches supply the superficial layer of the masseter muscle. In addition, the richest arborization of the perforating masseteric nerve branches is confined mostly to area V, approximately in accordance with the BTX injection point that is currently used clinically. Area V is thus strongly recommended as the most efficient and safe BTX injection area for the treatment of masseteric hypertrophy
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Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Orofacial Pain and Oral Medicine (구강내과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral Biology (구강생물학교실) > 1. Journal Papers
Yonsei Authors
Kim, Da Hye(김다혜)
Kim, Hyun Joo(김현주)
Kim, Hee Jin(김희진) ORCID logo https://orcid.org/0000-0002-1139-6261
Won, Sung Yoon(원성윤)
Choi, Jong Hoon(최종훈) ORCID logo https://orcid.org/0000-0003-3211-3619
Hu, Kyung Seok(허경석) ORCID logo https://orcid.org/0000-0002-9048-3805
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