scholarly journals Accuracy of Ultrasound-Guided and Non-guided Botulinum Toxin Injection Into Neck Muscles Involved in Cervical Dystonia: A Cadaveric Study

2020 ◽  
Vol 44 (5) ◽  
pp. 370-377
Author(s):  
Yun Dam Ko ◽  
Soo In Yun ◽  
Dahye Ryoo ◽  
Myung Eun Chung ◽  
Jihye Park
Keyword(s):  
Botulinum Toxin ◽  
Neck Muscles ◽  
Injection Technique ◽  
Ultrasound Guided ◽  
Upper Trapezius ◽  
Levator Scapulae ◽  
Group A ◽  
Splenius Capitis ◽  
Group B ◽  
Botulinum Toxin Injections

Objective To compare the accuracy of ultrasound-guided and non-guided botulinum toxin injections into the neck muscles involved in cervical dystonia.Methods Two physicians examined six muscles (sternocleidomastoid, upper trapezius, levator scapulae, splenius capitis, scalenus anterior, and scalenus medius) from six fresh cadavers. Each physician injected ultrasound-guided and non-guided injections to each side of the cadaver’s neck muscles, respectively. Each physician then dissected the other physician’s injected muscle to identify the injection results. For each injection technique, different colored dyes were used. Dissection was performed to identify the results of the injections. The muscles were divided into two groups based on the difficulty of access: sternocleidomastoid and upper trapezius muscles (group A) and the levator scapulae, splenius capitis, scalenus anterior, and scalenus medius muscles (group B).Results The ultrasound-guided and non-guided injection accuracies of the group B muscles were 95.8% and 54.2%, respectively (p<0.001), while the ultrasound-guided and non-guided injection accuracies of the group A muscles were 100% and 79.2%, respectively (p<0.05).Conclusion Ultrasound-guided botulinum toxin injections into inaccessible neck muscles provide a higher degree of accuracy than non-guided injections. It may also be desirable to consider performing ultrasound-guided injections into accessible neck muscles.

scholarly journals Anatomo-sonographic identification of the longissimus capitis and splenius cervicis muscles: principles for possible application to ultrasound-guided botulinum toxin injections in cervical dystonia

2021 ◽  
Author(s):  
Eleonore Brumpt ◽  
Sebastien Aubry ◽  
Fabrice Vuillier ◽  
Laurent Tatu
Keyword(s):  
Botulinum Toxin ◽  
The Body ◽  
Mastoid Process ◽  
Ultrasound Guided ◽  
Fresh Cadaver ◽  
Levator Scapulae ◽  
Spinous Processes ◽  
Anatomical Correlation ◽  
Magnetic Resonance Imaging Mri ◽  
Botulinum Toxin Injections

Abstract Objective The main objective of this study was to define and verify anatomo-sonographic landmarks for ultrasound-guided injection of botulinum toxin into the longissimus capitis (LC) and splenius cervicis (SC) muscles. Methods and results After a preliminary work of anatomical description of the LC and SC muscles, we identified these muscles on two cadavers and then on a healthy volunteer using ultrasound and magnetic resonance imaging (MRI) to establish a radio-anatomical correlation. We defined an anatomo-sonographic landmark for the injection of each of these muscles. The correct positioning of vascular glue into the LC muscle and a metal clip into the SC muscle of a fresh cadaver as verified by dissection confirmed the utility of the selected landmarks. Discussion For the LC muscle, the intramuscular tendon of the cranial part of the muscle appears to be a reliable anatomical landmark. The ultrasound-guided injection can be performed within the cranial portion of the muscle, between the intra-muscular tendon and insertion into the mastoid process at dens of the axis level. For the SC muscle, the surface topographic landmarks of the spinous processes of the C4–C5 vertebrae and the muscle body of the levator scapulae muscle seem to be reliable landmarks. From these, the ultrasound-guided injection can be carried out laterally by transfixing the body of the levator scapulae. Conclusion The study defined two cervical anatomo-sonographic landmarks for injecting the LC and SC muscles.

scholarly journals Alteration in Activation Pattern of Neck Muscles in Patients with Chronic Neck Pain

2015 ◽  
Vol 6 (1) ◽  
pp. 1-7
Author(s):  
Rajwant Kaur Chahal ◽  
Pravin Kumar
Keyword(s):  
Neck Pain ◽  
Chronic Neck Pain ◽  
Neck Muscles ◽  
Emg Activity ◽  
Activation Pattern ◽  
Maximum Voluntary Isometric Contraction ◽  
Upper Trapezius ◽  
Levator Scapulae ◽  
Significant Difference ◽  
Group B

ABSTRACT Objective The aim of this study was to investigate activation pattern of neck muscles in patients with chronic neck pain of nontraumatic origin during static tasks. Materials and methods Fifteen normal subjects were taken in group A and 15 patients with chronic neck pain of nontraumatic origin were taken in group B. Electromyography (EMG) activity was recorded from the sternocleidomastoid, anterior scalene, levator scapulae and upper trapezius muscles. Percentage maximum voluntary isometric contraction were calculated during static tasks, which included shoulder abduction to 90° and hold, shrug and hold, craniocervical flexion and hold. Results There was no significant (p > 0.05) difference found in activation pattern of neck muscles when we compared right and left sides within groups A and B. But when we compared between groups, group B showed a significant (p < 0.05) increased activation pattern in anterior scalene, sternocleidomastoid, upper trapezius compared to normal subject's neck muscles except levator scapulae which shows no significant difference between groups. Conclusion It is concluded from the study that, in patient of nontraumatic origin of chronic neck pain, all the patients showed a significant increased level of EMG activity in neck muscles during performance of static activities as compared to asymptomatic controls. How to cite this article Chahal RK, Kumar P. Alteration in Activation Pattern of Neck Muscles in Patients with Chronic Neck Pain. Int J Head Neck Surg 2015;6(1):1-7.

scholarly journals Surgery without knife: an ideal treatment for lactational breast abscess

2017 ◽  
Vol 5 (1) ◽  
pp. 261
Author(s):  
Amandeep Saharan ◽  
Satish Dalal ◽  
Mahavir Singh ◽  
Chisel Bhatia ◽  
Tulit Chhabra
Keyword(s):  
Randomized Study ◽  
Needle Aspiration ◽  
Breast Abscess ◽  
Ultrasound Guided ◽  
Incision And Drainage ◽  
Skin Changes ◽  
Lactating Mothers ◽  
Group A ◽  
Group B ◽  
Early Healing

Background: Incidence of breast abscess is 0.4 to 11% of all lactating mothers. Traditionally the treatment of breast abscess has been incision and drainage. Recently aspiration under ultrasound guidance is emerging as another treatment option and rapidly replace incision and drainageMethods: Authors carried out a prospective, randomized study involving 50 lactating women with breast abscess. In group A - 25 patients were managed by ultrasound guided needle aspiration and in group B - 25 patients were managed by incision and drainage.Results: In patients of group A, most breast abscesses resolved with one or two aspirations only, with early healing and lesser number of hospital visits as compared to patients in group B. There was no surgical scar and early resumption of breastfeeding was seen in group A.Conclusions: Ultrasound guided percutaneous aspiration is an effective modality of treatment of lactational breast abscess and it should be the first line of treatment, especially for smaller and unilocular breast abscesses while incision and drainage should be reserved for larger and multilocular abscesses with imminent skin changes.

scholarly journals ERCP plus endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage for malignant hilar biliary obstruction: a multicenter observational open-label study

Endoscopy ◽  
2020 ◽  
Vol 53 (01) ◽  
pp. 55-62 ◽  
Author(s):  
Pradermchai Kongkam ◽  
Theerapat Orprayoon ◽  
Chaloemphon Boonmee ◽  
Passakorn Sodarat ◽  
Orathai Seabmuangsai ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Biliary Drainage ◽  
Biliary Obstruction ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Ultrasound Guided ◽  
Group A ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction ◽  
Group B ◽  
Transhepatic Biliary Drainage

Abstract Background Endoscopic retrograde cholangiopancreatography (ERCP) may not provide complete biliary drainage in patients with Bismuth III/IV malignant hilar biliary obstruction (MHBO). Complete biliary drainage is accomplished by adding percutaneous transhepatic biliary drainage (PTBD). We prospectively compared recurrent biliary obstruction (RBO) rates between combined ERCP and endoscopic ultrasound-guided biliary drainage (EUS-BD) vs. bilateral PTBD. Methods Patients with MHBO undergoing endoscopic procedures (group A) were compared with those undergoing bilateral PTBD (group B). The primary outcome was the 3-month RBO rate. Results 36 patients were recruited into groups A (n = 19) and B (n = 17). Rates of technical and clinical success, and complications of group A vs. B were 84.2 % (16/19) vs. 100 % (17/17; P = 0.23), 78.9 % (15/19) vs. 76.5 % (13/17; P > 0.99), and 26.3 % (5/19) vs. 35.3 % (6/17; P = 0.56), respectively. Within 3 and 6 months, RBO rates of group A vs. group B were 26.7 % (4/15) vs. 88.2 % (15/17; P  = 0.001) and 22.2 % (2/9) vs. 100 % (9/9; P = 0.002), respectively. At 3 months, median number of biliary reinterventions in group A was significantly lower than in group B (0 [interquartile range] 0–1 vs. 1 [1–2.5]), respectively (P < 0.001). Median time to development of RBO was longer in group A than in group B (92 [56–217] vs. 40 [13.5–57.8] days, respectively; P  =  0.06). Conclusions Combined ERCP and EUS procedures provided significantly lower RBO rates at 3 and 6 months vs. bilateral PTBD, with similar complication rates and no significant mortality difference.

Visualization rate of internal mammary sentinel lymph nodes with modified technique of radiotracer injection.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 99-99
Author(s):  
Yong-sheng Wang ◽  
Peng-fei Qiu ◽  
Guo-ren Yang ◽  
Yan-bing Liu ◽  
Bin-bin Cong ◽  
...  
Keyword(s):  
High Volume ◽  
Sentinel Lymph Nodes ◽  
Injection Technique ◽  
Modified Technique ◽  
Injection Volume ◽  
Internal Mammary ◽  
Radiotracer Injection ◽  
Group A ◽  
Group B ◽  
Ultrasonographic Guidance

99 Background: Even though the 2009 AJCC incorporated the internal mammary sentinel lymph node biopsy (IM-SLNB) concept, there has been limited change in surgeons practice patterns due to the low visualization rate of the internal mammary sentinel lymph nodes (IM-SLNs) with the conventional injection technique (average 13%, 0~37%). In this prospective study, different radiotracer injection techniques were evaluated to achieve a relative high visualization and detection rate of IM-SLNs (NCT01642511). Methods: The 190 patients enrolled in this study were divided into three groups according to the study period and radiotracer (99mTc-labeled sulfur colloid) injection technique. Group A: conventional technique (radiotracer injection only into the tumor quadrant) for the initial 58 cases; Group B: two-quadrant injection at the 6 and 12 o’clock positions, 2.0~3.0 cm from nipple in the latter 132 cases. Group B was then separated into two groups according to the radiotracer injection volume: Group B1, low volume (<0.5ml/point, n=41); Group B2, high volume (≥0.5ml/point, n=91). Radiotracer was injected into the parenchyma under the ultrasonographic guidance for all patients. IM-SLNB was performed for patients with IM-SLNs visualized on preoperative lymphoscintigraphy and/or detected by intraoperative gamma probe. Results: Group B was associated with a significantly higher IM-SLNs visualization rate (76.5%, 101/132) compared to Group A (15.5%, 9/58, P=0.000), and Group B2 with the highest visualization rate (86.8% vs. 53.7% Group B1, P=0.000). All techniques had the same visualization rate of the axillary SLNs (P=0.915). The visualization rate of IM-SLNs was related to the patient’s age (P=0.037) and injection volume (P=0.000). The successful rate of IM-SLNB was 92.3%, and arrived 100% after 20 cases learning curve. The postoperative IM-SLNB complications were 0. Conclusions: Modified technique of radiotracer injection (Qiu's injection technique: two-quadrant, high volume and ultrasonographic guidance) significantly improved the visualization rate of IM-SLNs, provided an effective technique to evaluate the status of internal mammary, and would promote research on the IM-SLNB.

scholarly journals Quinolone Prophylaxis in Transrectal Ultrasound Guided Prostate Biopsy: An Eight-Year Single Center Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Bing-Juin Chiang ◽  
Yeong Shiau Pu ◽  
Shiu-Dong Chung ◽  
Shih-Ping Liu ◽  
Hong-Jeng Yu ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Transrectal Ultrasound ◽  
Infectious Complications ◽  
Pipemidic Acid ◽  
Ultrasound Guided ◽  
E Coli ◽  
Single Center Experience ◽  
Significant Difference ◽  
Group A ◽  
Group B

We retrospectively evaluated the efficacy of prophylaxis with pipemidic acid and levofloxacin in transrectal ultrasound guided prostate biopsy (TRUSP-Bx). From January 2002 to December 2004, patients receiving oral pipemidic acid 500 mg twice daily for three days with or without a preoperative intravenous cefazolin 1 gm injection comprised group A. Between January 2005 and December 2009, patients receiving oral levofloxacin 500 mg one hour before biopsy comprised group B. We calculated the annual febrile urinary tract infection (fUTI) rates. Patients’ characteristics, including age, prophylactic antibiotics, biopsy core numbers, pathologic results, PSA, and the spectrums and susceptibility of pathogens, were also evaluated. A total of 1313 (35.5%) patients belonged to group A, while 2381 (64.5%) patients belonged to group B. Seventy-three patients experienced postoperative infectious complications. There was a significant difference in the fUTI rate between groups A and B (3.7% versus 1.0%,P<0.001). The yearly fUTI rates varied from 0.6 to 3.9% between 2002 and 2009. Of the 73 patients with fUTI, those receiving levofloxacin prophylaxis were more likely to harbor fluoroquinolone-resistant pathogens (P<0.001).E. coliwas the most common pathogen in both groups. Levofloxacin remains effective and appears superior to pipemidic acid based prophylaxis.

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