Cadaveric and in vivo validation of needle placement in the medial pterygoid muscle.

Musculoskelet Sci Pract. 2020 May 22;49:102197

Authors: Mesa-Jiménez JA, Fernández-de-Las-Peñas C, Koppenhaver SL, Sánchez-Gutiérrez J, Arias-Buría JL

Abstract
BACKGROUND: Evidence suggests that medial pterygoid muscle plays an important role in temporomandibular pain. Therapeutic approaches targeting this muscle are needed.
OBJECTIVE: To determine if a solid needle accurately penetrates the medial pterygoid muscle during the application of dry needling.
DESIGN: A cadaveric and human descriptive study.
METHODS: Needling insertion of the medial pterygoid was conducted in 5 fresh cadaver and 5 subjects with temporomandibular pain. Needling insertion was performed using a 40 mm needle inserted at the inferior angle of the mandibular bone. The needle was advanced from an inferior to superior direction into the medial pterygoid to a maximum depth of 30 mm. In cadavers, medial pterygoid placement was assessed by observation after resecting the superficial overlying tissues. In patients, medial pterygoid placement was assessed by self-reported pain referral during insertion.
RESULTS: Accurate needle penetration of the medial pterygoid was observed in all fresh cadavers and pain referral was reported by 4/5 patients during needling insertion.
CONCLUSION: Results from both cadavers and patients support the assertion that needling of the medial pterygoid can be accurately conducted.

PMID: 32479337 [PubMed – as supplied by publisher]