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

Background: Evidence suggests that medial pterygoid muscle plays an important role in temporomandibular pain. Therapeutic approaches targeting this muscle are needed.

Objective: To determine if a solid needle accurately penetrates the medial pterygoid muscle during the application of dry needling.

Design: A cadaveric and human descriptive study.

Methods: 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.

Results: 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.

Conclusion: Results from both cadavers and patients support the assertion that needling of the medial pterygoid can be accurately conducted.