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Ideal Injection Points for Botulinum Neurotoxin for Pectoralis Minor Syndrome: A Cadaveric Study

Authors
 Ji-Hyun Lee  ;  Hyung-Jin Lee  ;  Kyu-Ho Yi  ;  Kang-Woo Lee  ;  Young-Chun Gil  ;  Hee-Jin Kim 
Citation
 TOXINS, Vol.15(10) : 603, 2023-10 
Journal Title
TOXINS
Issue Date
2023-10
MeSH
Botulinum Toxins* / therapeutic use ; Botulinum Toxins, Type A* ; Cadaver ; Humans ; Injections ; Injections, Intramuscular ; Pectoralis Muscles / innervation
Keywords
Pectoralis Minor Syndrome ; Sihler staining ; botulinum neurotoxin ; pectoralis minor muscle ; thoracic outlet syndrome
Abstract
Pectoralis Minor Syndrome (PMS) causes significant discomfort due to the compression of the neurovascular bundle within the retropectoralis minor space. Botulinum neurotoxin (BoNT) injections have emerged as a potential treatment method; however, their effectiveness depends on accurately locating the injection site. In this study, we aimed to identify optimal BoNT injection sites for PMS treatment. We used twenty-nine embalmed and eight non-embalmed human cadavers to determine the origin and intramuscular arborization of the pectoralis minor muscle (Pm) via manual dissection and Sihler’s nerve staining techniques. Our findings showed the Pm’s origin near an oblique line through the suprasternal notch, with most neural arborization within the proximal three-fourths of the Pm. Blind dye injections validated these results, effectively targeting the primary neural arborized area of the Pm at the oblique line’s intersection with the second and third ribs. We propose BoNT injections at the arborized region within the Pm’s proximal three-fourths, or the C region, for PMS treatment. These findings guide clinicians towards safer, more effective BoNT injections.
Files in This Item:
T202401513.pdf Download
DOI
10.3390/toxins15100603
Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Oral Biology (구강생물학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hee Jin(김희진) ORCID logo https://orcid.org/0000-0002-1139-6261
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198700
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