Ultrasound‐Guided Jaw Muscle Injection

The temporomandibular joint (TMJ) is the joint that connects your mandible (lower jaw) to your skull. It allows your jaw to open and close, enabling you to speak and eat.

The irritation of the temporomandibular joint (TMJ) in the jaw can result in temporal tendonitis. It is the inflammation and tenderness of the temporalis tendon where it inserts into the coronoid process of the mandible (a thin, triangular eminence, which is flattened from side to side and varies in shape and size).

Treatment of temporal tendonitis can involve multiple processes, such as injection therapy with a long-lasting local anesthetic and a steroid, sarapin, or prolotherapy.
Due to the complex and dense anatomy of the region, blind injection of the temporalis may result in an unintentional injury.

A novel and effective technique, ultrasound-guided injection of the temporalis tendon, is described. The anatomic location and size of the temporalis tendon make it mandatory to use ultrasound to ensure precision.

Which ultrasound scanner needed for Jaw muscle injections? 

Anesthesiologists will need the Mini Linear Handheld Wi-Fi Ultrasound Scanner MLCD for this procedure.

The Mini linear probe allows the practitioner to visualize the needle in real-time as it enters the jaw and traverses to the temporalis tendon.

The ultrasound‐guided anatomic technique ensures correct injection of the direct temporalis tendon and prevents potential injury of any of the closely adjacent structures. This technique is practical for both the diagnosis and treatment of patients presenting with chronic facial pain syndromes.

MLCD enables doctors to control the needle insertion path and, if needed, to modify the needle depth or angle. It also offers High-resolution ultrasound images and High intensity focused digital thanks to its higher frequency (10MHz / 12MHz / 14MHz.). This allows the practitioner to visualize the mandibular condyle on the screen. 

To visualize the temporalis tendon, the transducer should be placed inferior to the anterior aspect of the zygomatic arch (cheekbone).

When the mandible is in the closed‐mouth position, the coronoid process is anatomically underneath the zygomatic arch and is therefore inaccessible. Opening the mouth fully will bring the coronoid process out from under the arch to be visualized. 

The temporalis tendon insertion can be visualized in the sagittal plane (long axis) in both the open‐ and closed‐mouth positions but is best visualized in the axial plane (short axis) in the open‐mouth projection, which is optimal for injection.

Once the musculotendinous junction is visualized, the needle is then directed to the medial insertion imaging is required to locate the distal temporalis tendon and to confirm the presence of temporal tendinosis. 

MLCD is easy to use during such procedures thanks to its lightweight and small design. It is a wireless device, therefore; it can be used without worrying about fixing cables. It is also iOS and Android compatible to give superior image quality.

References: TMJ (Temporomandibular Joint) Disorders , Carolina TMJ Blog , Temporalis Tendonitis , Ultrasound-Guided Injection of the Temporalis Tendon

Disclaimer: Although the information we provide is used by different doctors and medical staff to perform their procedures and clinical applications, the information contained in this article is for consideration only. SONOSIF is not responsible neither for the misuse of the device nor for the wrong or random generalizability of the device in all clinical applications or procedures mentioned in our articles. Users must have the proper training and skills to perform the procedure with each ultrasound scanner device.

The products mentioned in this article are only for sale to medical staff (doctors, nurses, certified practitioners, etc.) or to private users assisted by or under the supervision of a medical professional.