Customized EMG needle insertion guide for the muscle afferent block of jaw-deviation and jaw-opening dystonias.
OBJECTIVE
Jaw-opening and jaw-deviation dystonias are characterized by mouth opening or lateral shift of the mandible due to involuntary contraction of the lateral pterygoid muscle, causing difficulties in speech or mastication. We introduce the method of muscle afferent block by using a removable device for inserting a hollow electromyographic needle.


METHODS
A technique for fabricating a customized needle insertion guide into the lateral pterygoid muscle is described. Using the device, intramuscular injection of lidocaine and ethanol was performed in 3 patients with jaw-opening dystonia and 2 with jaw-deviation dystonia. Subjective improvement was assessed on a linear self-rating scale ranging from 0 (no improvement) to 100 points (complete cure).


RESULTS
The overall subjective improvement was 72% +/- 16.4% without major side effects.


CONCLUSIONS
The device is very useful for safe and accurate injection into the lateral pterygoid muscle. The muscle afferent block is effective for jaw-opening and jaw-deviation dystonias.
Yoshida
K
K
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Japan.
Kaji
R
R
Takagi
A
A
Iizuka
T
T
D000328:Adult; D000344:Afferent Pathways / Q000187:drug effects; D000368:Aged; D000779:Anesthetics, Local; D002908:Chronic Disease; D020821:Dystonic Disorders / Q000175:diagnosis / Q000628:therapy*; D004566:Electrodes; D004576:Electromyography / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D000431:Ethanol; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000295:instrumentation / Q000379:methods; D007571:Jaw Diseases / Q000175:diagnosis / Q000628:therapy*; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D009339:Needles; D009407:Nerve Block / Q000295:instrumentation* / Q000379:methods
D000779:Anesthetics, Local; D000431:Ethanol; D008012:Lidocaine