Citation Information :
Al-Tairi NH, Al-Sharaee YA, Alhajj MN. Lateral Pterygoid Muscle Location in Relation to Preauricular Skin Measured from CT Scans among a Sample of Yemeni Adults. J Contemp Dent Pract 2021; 22 (5):522-526.
Aim: The aim of this study was to determine the lateral pterygoid muscle (LPM) in relation to preauricular skin measured from computed tomography (CT) scan measurements.
Materials and methods: CT scans of 160 patients aged between 18 and 75 years were retrospectively collected and analyzed, and the distances were measured to determine the location of the LPM center in relation to the preauricular skin. On axial CT crossing the maximum muscle width, two lines [the first line is below the center of the zygomatic arch (first position), while the second line was 5 mm posterior to the first one (second position)] were drawn from the preauricular skin to the medial border and then extended to the lateral border of the muscle. These measurements were used to calculate the distance to the center of the muscle mathematically. Data were statistically analyzed, and the differences between both genders and both sides were investigated. The level of significance was set at p-value <0.05.
Results: Males displayed larger mean values in two positions (36.6 ± 2.25 and 35.97 ± 4.19, respectively) than females (33.66 ± 4.46 and 32.80 ± 3.21, respectively). The difference between both genders was found to be statistically significant. Measurements on the right side were also larger than those on the left side, but with no significant difference.
Conclusion: LPM center can be approached safely in males by inserting the needle about 36 mm at the first position and 33 mm at the second position. However, in females, these distances are located 3 mm shorter in both positions.
Clinical significance: The outcome of this study will provide the clinicians with measurements that can help in directing the needle or electromyography (EMG) electrode during the extraoral injection technique of the LPM.
Honée GL. The anatomy of the lateral pterygoid muscle. Acta Morphol Neerl Scand 1972;10(4):331–340. PMID: 4657703.
Standring S, Gray H. Gray's anatomy : the anatomical basis of clinical practice. 40th ed. Edinburgh: Churchill Livingstone/Elsevier; 2008. 538 p.
Usui A, Akita K, Yamaguchi K. An anatomic study of the divisions of the lateral pterygoid muscle based on the findings of the origins and insertions. Surg Radiol Anat 2008;30(4):327–333. DOI: 10.1007/s00276-008-0329-2.
Rees LA. The structure and function of the mandibular joint. Br Dent J 1954;96:125–133.
Sugisaki M, Komori E, Nakazawa M, et al. Anatomical studies of the lateral pterygoid muscle by the superior approach and a review of the literature. Jpn J Oral Maxil Surg 1986;32(5):718–730. DOI: 10.5794/jjoms.32.718.
Porter MR. The attachment of the lateral pterygoid muscle to the meniscus. J Prosthet Dent 1970;24(5):555–562. DOI: 10.1016/0022-3913(70)90063-6.
Troiano MF. New concept of the insertion of the lateral pterygoid muscle. J Oral Surg 1967;25(4):337–340. PMID: 5229276.
Akita K, Shimokawa T, Sato T. Positional relationships between the masticatory muscles and their innervating nerves with special reference to the lateral pterygoid and the midmedial and discotemporal muscle bundles of temporalis. J Anat 2000;197(Pt 2):291–302. DOI: 10.1046/j.1469-7580.2000.19720291.x.
Akita K, Shimokawa T, Sato T. An anatomic study of the positional relationships between the lateral pterygoid muscle and its surrounding nerves. Eur J Anat 2003;7(S1):5–14.
Foucart J, Girin J, Carpentier P. Innervation of the human lateral pterygoid muscle. Surg Radiol Anat 1998;20(3):185–189. DOI: 10.1007/BF01628893.
Smith RD, Marcarian H. The neuromuscular spindles of the lateral pterygoid muscle. Anat Anz 1967;120(1):47. PMID: 4232565.
McNamara Jr JA. The independent functions of the two heads of the lateral pterygoid muscle. Am J Anat 1973;138(2):197–205. DOI: 10.1002/aja.1001380206.
Wilkinson T. The relationship between the disk and the lateral pterygoid muscle in the human temporomandibular joint. J Prosthet Dent 1988;60(6):715–724. DOI: 10.1016/0022-3913(88)90406-4.
Arıncı A, Güven E, Yazar M, et al. Effect of injection of botulinum toxin on lateral pterygoid muscle used together with the arthroscopy in patients with anterior disk displacement of the temporomandibular joint. Kulak Burun Bogaz Ihtis Derg 2009;19(3):122–129. PMID: 19857189.
Mendes RA, Upton L. Management of dystonia of the lateral pterygoid muscle with botulinum toxin A. Br J Oral Maxillofac Surg 2009;47(6):481–483. DOI: 10.1016/j.bjoms.2008.08.010.
Goodpaster BH, Thaete FL, Kelley DE. Composition of skeletal muscle evaluated with computed tomography. Ann N Y Acad Sci 2000;904(1):18–24. DOI: 10.1111/j.1749-6632.2000.tb06416.x.
Lell MM, Wildberger JE, Alkadhi H, et al. Evolution in computed tomography: the battle for speed and dose. Invest Radiol 2015;50(9):629–644. DOI: 10.1097/RLI.0000000000000172.
Mazonakis M, Damilakis J. Computed tomography: what and how does it measure? Eur J Radiol 2016;85(8):1499–1504. DOI: 10.1016/j.ejrad.2016.03.002.
Alexoudi A, Dalivigka Z, Siatouni A, et al. Oromandibular dystonia: a case report of the lateral pterygoid muscle involvement and treatment with botulinum toxin A. Clin Pract 2016;6(3):862. DOI: 10.4081/cp.2016.862.
Martos-Díaz P, Rodríguez-Campo F, Bances-Del Castillo R, et al. Lateral pterygoid muscle dystonia. A new technique for treatment with botulinum toxin guided by electromyography and arthroscopy. Med Oral Pathol Oral Cir Bucal 2011;16(1):e96–e99. DOI: 10.4317/medoral.16.e96.
Daelen B, Thorwirth V, Koch A. Treatment of recurrent dislocation of the temporomandibular joint with type A botulinum toxin. Int J Oral Maxillofac Surg 1997;26(6):458–460. DOI: 10.1016/s0901-5027(97)80014-8.
Stark TR, Perez CV, Okeson JP. Recurrent TMJ dislocation managed with botulinum toxin type a injections in a pediatric patient. Pediatr Dent 2015;37(1):65–69. PMID: 25685976.
Fu KY, Chen HM, Sun ZP, et al. Long-term efficacy of botulinum toxin type A for the treatment of habitual dislocation of the temporomandibular joint. Br J Oral Maxillofac Surg 2010;48(4):281–284. DOI: 10.1016/j.bjoms.2009.07.014.
Sanjuan-Sanjuan A, Alamillos-Granados FJ, Dean-Ferrer A, et al. Electromyography assisted application of botulinum toxin in pterygoid musculature for the treatment of masticatory myofascial pain. Rev Esp Cirug Oral Maxilofac 2019;41(2):54–60. DOI: 10.20986/recom.2019.1017/2018.
Bakke M, Møller E, Werdelin LM, et al. Treatment of severe temporomandibular joint clicking with botulinum toxin in the lateral pterygoid muscle in two cases of anterior disc displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100(6):693–700. DOI: 10.1016/j.tripleo.2004.11.019.
Itoh K, Asai S, Ohyabu H, et al. Effects of trigger point acupuncture treatment on temporomandibular disorders: a preliminary randomized clinical trial. J Acupunct Meridian Stud 2012;5(2):57–62. DOI: 10.1016/j.jams.2012.01.013.
Gonzalez-Perez LM, Infante-Cossio P, Granados-Nunez M, et al. Deep dry needling of trigger points located in the lateral pterygoid muscle: efficacy and safety of treatment for management of myofascial pain and temporomandibular dysfunction. Med Oral Patol Oral Cir Bucal 2015;20(3):e326. DOI: 10.4317/medoral.20384.
Brodsky MA, Swope DM, Grimes D. Diffusion of botulinum toxins. Tremor Other Hyperkinet Mov 2012;2. DOI: 10.7916/D88W3C1M.
Shaari CM, George E, Wu BL, et al. Quantifying the spread of botulinum toxin through muscle fascia. Laryngoscope 1991;101(9):960–964. DOI: 10.1288/00005537-199109000-00006.
Hallett M. Explanation of timing of botulinum neurotoxin effects, onset and duration, and clinical ways of influencing them. Toxicon 2015;107:64–67. DOI: 10.1016/j.toxicon.2015.07.013.
Mahan PE, Wilkinson TM, Gibbs CH, et al. Superior and inferior bellies of the lateral pterygoid muscle EMG activity at basic jaw positions. J Prosthet Dent 1983;50(5):710–718. DOI: 10.1016/0022-3913(83)90214-7.
Lee DH, Yu HS. Masseter muscle changes following orthognathic surgery: a long-term three-dimensional computed tomography follow-up. Angle Orthod 2012;82(5):792–798. DOI: 10.2319/111911-717.1.
Maki K, Miller A, Okano T, et al. Cortical bone mineral density in asymmetrical mandibles: a three-dimensional quantitative computed tomography study. Eur J Orthod 2001;23(3):217–232. DOI: 10.1093/ejo/23.3.217.
Kaviani F, Rashid RJ, Shahmoradi Z, et al. Detection of foreign bodies by spiral computed tomography and cone beam computed tomography in maxillofacial regions. J Dent Res Dent Clin Dent Prospects 2014;8(3):166. DOI: 10.5681/joddd.2014.030.
Chan HJ, Woods M, Stella D. Mandibular muscle morphology in children with different vertical facial patterns: a 3-dimensional computed tomography study. Am J Orthod Dentofacial Orthop 2008;133(1):10. e1–10. e13. DOI: 10.1016/j.ajodo.2007.05.013.
Xu J, Yuasa K, Yoshiura K, et al. Quantitative analysis of masticatory muscles using computed tomography. Dentomaxillofac Radiol 1994;23(3):154–158. DOI: 10.1259/dmfr.23.3.7835516.
Tsiklakis K, Syriopoulos K, Stamatakis H. Radiographic examination of the temporomandibular joint using cone beam computed tomography. Dentomaxillofac Radiol 2004;33(3):196–201. DOI: 10.1259/dmfr/27403192.
Ludlow JB, Laster WS, See M, et al. Accuracy of measurements of mandibular anatomy in cone beam computed tomography images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(4):534–542. DOI: 10.1016/j.tripleo.2006.04.008.
Kuribayashi A, Watanabe H, Imaizumi A, et al. Bifid mandibular canals: cone beam computed tomography evaluation. Dentomaxillofac Radiol 2010;39(4):235–239. DOI: 10.1259/dmfr/66254780.
Pons M, Meyer C, Euvrard E, et al. MR-guided navigation for botulinum toxin injection in the lateral pterygoid muscle. First results in the treatment of temporomandibular joint disorders. J Stomatol Oral Maxillofac Surg 2019;120(3):188–195. DOI: 10.1016/j.jormas.2018.11.002.
Orfanos T, Sarinnaphakorn L, Murray G, et al. Placement and verification of recording electrodes in the superior head of the human lateral pterygoid muscle. Arch Oral Biol 1996;41(5):493–503. DOI: 10.1016/0003-9969(95)00142-5.
Martín-Granizo R, Maniegas L, Colorado L, et al. Direct infiltration of botulinum toxin into the pterygoid lateral muscle for repositioning of the disc during arthroscopy of the temporomandibular joint. Br J Oral Maxillofac Surg 2018;56(8):769–771. DOI: 10.1016/j.bjoms.2018.07.014.
Shalash AS, Abushouk AI, Elsherbeny MY, et al. Refractory open jaw oromandibular tardive dystonia with a sensory trick, treated with botulinum toxin: a case report. Neurol India 2019;67(4):1110. DOI: 10.4103/0028-3886.266235.
Koole P, Beenhakker F, de Jongh HJ, et al. A standardized technique for the placement of electrodes in the two heads of the lateral pterygoid muscle. CRANIO® 1990;8(2):154–162. DOI: 10.1080/08869634.1990.11678309.