title: Cadaveric validation of dry needle placement in the lateral pterygoid muscle.
abstract: OBJECTIVE
  The aim of this anatomical study was to determine if a needle is able to reach the lateral pterygoid muscle during the application of dry needling technique.
  
  
  METHODS
  A dry needling approach using 2 needles of 50 to 60 mm in length, one inserted over the zygomatic process posterior at the obituary arch (for the superior head) and other inserted below the zygomatic process between the mandibular condyle and the coronoid process (for the inferior head), was proposed. A progressive dissection into 3 stages was conducted into 2 heads of fresh male cadavers. First, dry needling of the lateral pterygoid muscle was applied on the cadaver. Second, a block dissection containing the lateral pterygoid was harvested. Finally, the ramus of the mandible was sectioned by osteotomy to visualize the lateral pterygoid muscle with the needle placements.
  
  
  RESULTS
  With the needles inserted into the cadaver, the block dissection revealed that the superior needle reached the superior (sphenoid) head of the lateral pterygoid muscle and the inferior needle reached the inferior (pterygoid) head of the muscle. At the final stage of the dissection, when the ramus of the mandible was sectioned by osteotomy, it was revealed that the superior needle entered into the belly of the superior head of the lateral pterygoid muscle.
  
  
  CONCLUSIONS
  This anatomical study supports that dry needling technique for the lateral pterygoid muscle can be properly conducted with the proposed approach.
authors.affiliation: Professor, Department of Physical Therapy, Universidad San-Pablo CEU, Madrid, Spain; Professor, Máster Oficial en Dolor Orofacial y Disfunción Cráneo-Mandibular, Universidad San-Pablo CEU, Madrid, Spain.
authors.forename: Juan A
authors.initials: JA
authors.lastname: Mesa-Jiménez
authors.affiliation: Clinician, Department of Maxillo-Facial Surgery, Hospital Clínico San Carlos, Madrid, Spain; Professor, Máster Oficial en Dolor Orofacial y Disfunción Cráneo-Mandibular, Universidad San-Pablo CEU, Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Sánchez-Gutiérrez
authors.affiliation: Clinician, Máster Oficial en Dolor Orofacial y Disfunción Cráneo-Mandibular, Universidad San-Pablo CEU, Madrid, Spain.
authors.forename: José L
authors.initials: JL
authors.lastname: de-la-Hoz-Aizpurua
authors.affiliation: Professor and Clinical Researcher, Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation of Universidad Rey Juan Carlos, Alcorcón, Spain; Clinical Researcher, Cátedra de Investigación y Docencia en Fisioterapia, Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
authors.forename: César
authors.initials: C
authors.lastname: Fernández-de-las-Peñas
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods; D000368:Aged; D059925:Anatomic Landmarks / Q000033:anatomy & histology*; D063405:Anatomic Variation; D002102:Cadaver; D004210:Dissection; D006801:Humans; D008297:Male; D009339:Needles; D011626:Pterygoid Muscles / Q000033:anatomy & histology*; D012494:Sampling Studies; D013704:Temporomandibular Joint / Q000033:anatomy & histology*
keywords: Dry Needling; Pterygoid Muscles; Temporomandibular Joint Dysfunction Syndrome