The anatomy of temporal muscle in botulinum toxin injection

측두근 보툴리눔 독소 주사 시 고려해야 할 해부학

  • Lee, Won-Kang (Department of Orofacial Pain and Oral Medicine, College of Dentistry, Yonsei University) ;
  • Choi, Young-Chan (Department of Orofacial Pain and Oral Medicine, College of Dentistry, Yonsei University) ;
  • Hong, Jung-Hun (Department of Orofacial Pain and Oral Medicine, College of Dentistry, Yonsei University) ;
  • Kim, Seong-Teak (Department of Orofacial Pain and Oral Medicine, College of Dentistry, Yonsei University)
  • 이원강 (연세대학교 치과대학 구강내과학교실) ;
  • 최영찬 (연세대학교 치과대학 구강내과학교실) ;
  • 홍정훈 (연세대학교 치과대학 구강내과학교실) ;
  • 김성택 (연세대학교 치과대학 구강내과학교실)
  • Received : 2014.06.16
  • Accepted : 2014.08.12
  • Published : 2014.09.30


Botulinum toxin has been used for treating chronic migraine under US Food and Drug Administration approval since 2010. However there is no definitive guideline for injection point. The aim of this study is to propose an effective and safe injection guideline by reviewing the previous studies.


  1. Zhou JY, Wang D. An update on botuliunm toxin A injection of trigger points for myofascial pain. Curr Pain Headache Rep 2014;18:386.
  2. Aurora SK, Dodick DW, Turkel CC, DeGryse RE, Silberstein SD, Lipton RB, Diener HC, Brin MF; PREEMPT 1 Chronic Migraine Study Group. OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 1 trial. Cephalagia 2010;30:793-803.
  3. Ko GS, Kwak HH, Kim GC, Kim MS, Kim SH, Kim HJ, Kim HJ, Park GP, Park BG, Park BS, Bae YC, Lee YH, Lee EJ, Lee HS, Jeong HS, Cho SW, Cho US, Huh GS. Textbook of the gross anatomy. 1st ed. Seoul; Hyunmoonsa; 2007. p. 331-71.
  4. Agur AM. Grant's atlas of anatomy. 9th ed. Maryland; Williams and Wilkins; 1991. p. 494-505.
  5. Abrahams PH, Marks Jr SC, Hutchings RT. Mc- Minn's colour atlas of human anatomy. 5th ed. Edinburgh; Mosby; 2003. p. 48-57.
  6. Gaudy JF, Zouaoui A, Bravetti P, Charrier JL, Laison F. Functional anatomy of the human temporal muscle. Surg Radiol Anat 2001;23:389-98.
  7. Geers C, Nyssen-Behets C, Cosnard G, Lengele B. The deep belly of the temporalis muscle: an anatomical, histological and MRI study. Surg Radiol Anat 2005;27:184-91.
  8. Benateau H, Alix T, Labbe D, Elissalde JM, Salame E. Anatomic study of the tendinous insertion lamina of the temporalis muscle. Surg Radiol Anat 2004;26:281-4.
  9. Burggasser G, Happak W, Gruber H, Freilinger G. The temporalis: blood supply and innervations. Plast Reconstr Surg 2002;109:1862-9.
  10. Nakajima H, Imanishi N, Minabe T. The arterial anatomy of the temporal region and the vascular basis of various temporal flaps. Br J Plast Surg 1995;48:439-50.
  11. Chang Y, Cantelmi D, Wisco JJ, Fattab A, Hannam AG, Agur AM. Evidence for the functional compartmentalization of the temporalis muscle: a 3-Dimensional study of innervations. J Oral Maxillofac Surg 2013;71:1170-7.
  12. Elazab EE, Abdel-Hameed FA. The arterial supply of the temporalis muscle. Surg Radiol Anat 2006;28:241-7.
  13. Cvetko E. A case of an unusual arrangement of numerous tributaries to the middle temporal vein and its fenestration. Surg Radiol Anat 2013;35:355-7.
  14. Gerwin R. Botulinum toxin treatment of myofacial pain: a critical review of the literature. Curr Pain Headache Rep 2012;16:413-22.