title: Anatomical recommendations for safe botulinum toxin injection into temporalis muscle: a simplified reproducible approach.
abstract: OBJECTIVE
  The objective of this study was to simplify the anatomically safe and reproducible approach for BoNT injection and to generate a detailed topographic map of the important anatomical structures of the temporal region by dividing the temporalis into nine equally sized compartments.
  
  
  METHODS
  Nineteen sides of temporalis muscle were used. The topographies of the superficial temporal artery, middle temporal vein, temporalis tendon, and the temporalis muscle were evaluated. Also evaluated was the postural relations among the foregoing anatomical structures in the temporalis muscle, pivoted upon a total of nine compartments.
  
  
  RESULTS
  The temporalis above the zygomatic arch exhibited an oblique quadrangular shape with rounded upper right and left corners. The distance between the anterior and posterior margins of the temporalis muscle was equal to the width of the temporalis rectangle, and the distance between the reference line and the superior temporalis margin was equal to its height. The mean ratio of width to height was 5:4.
  
  
  CONCLUSIONS
  We recommend compartments Am, Mu, and Pm (coordinates of the rectangular outline) as areas in the temporal region for BoNT injection, because using these sites will avoid large blood vessels and tendons, thus improving the safety and reproducibility of the injection.
authors.affiliation: Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul, South Korea.
authors.forename: Won-Kang
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-749, South Korea.
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Bae
authors.affiliation: Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-749, South Korea.
authors.forename: Kyung-Seok
authors.initials: KS
authors.lastname: Hu
authors.affiliation: Department of Oral Anatomy and Neurobiology, Osaka University Graduate School of Dentistry, Osaka, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul, South Korea. k8756050@yuhs.ac.|Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, Yonsei University College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-749, South Korea. k8756050@yuhs.ac.
authors.forename: Seong-Taek
authors.initials: ST
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001905:Botulinum Toxins / Q000008:administration & dosage*; D002102:Cadaver; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000009:adverse effects / Q000379:methods; D008297:Male; D015203:Reproducibility of Results; D013699:Temporal Arteries / Q000033:anatomy & histology*; D013703:Temporal Muscle / Q000033:anatomy & histology* / Q000098:blood supply; D013710:Tendons / Q000033:anatomy & histology; D015050:Zygoma / Q000033:anatomy & histology*
chemical_list: D001905:Botulinum Toxins
keywords: Botulinum toxin; Bruxism; Injection point; Temporal region; Temporalis muscle