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

• Published in: Musculoskeletal science & practice 2020-10, Vol.49, p.102197-102197, Article 102197
• Main Authors: Mesa-Jiménez, Juan A., Fernández-de-las-Peñas, Cesar, Koppenhaver, Shane L., Sánchez-Gutiérrez, Jesús, Arias-Buría, José L.
• Format: Article
• Language: English
• Subjects: Cadaver; Dry needling; Medial pterygoid; Temporomandibular pain
• ISSN: 2468-7812; 2468-7812
• DOI: 10.1016/j.msksp.2020.102197

Evidence suggests that medial pterygoid muscle plays an important role in temporomandibular pain. Therapeutic approaches targeting this muscle are needed. To determine if a solid needle accurately penetrates the medial pterygoid muscle during the application of dry needling. A cadaveric and human descriptive study. 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. 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. Results from both cadavers and patients support the assertion that needling of the medial pterygoid can be accurately conducted. •The needle accurately pierced the medial pterygoid muscle.•Needling insertion reproduced the referred pain described for the medial pterygoid.•No neurovascular structure was closed to the needle.