2023 Workshop Handout Bundle-NMUS Anatomy of the Head and Neck

NMUS Anatomy of the Head and Neck

Pdf Summary

Dr. Katharine E. Alter's presentation at the 2023 AANEM Annual Meeting provides an in-depth review of the anatomy of the head and neck, particularly tailored for Botox (BoNT) chemodenervation procedures. The goals of the session include understanding the functional and cross-sectional anatomy of the head and neck, recognizing conditions treatable with BoNT, and effectively using ultrasound (US) for procedural guidance.<br /><br />Key topics covered in the presentation:<br /><br />1. <strong>Functional Anatomy Review</strong>: The presentation highlights the complex anatomy of the head and neck, involving multiple muscles, vessels, and nerves organized in layers. Understanding the anatomy is crucial for accurate BoNT injections.<br /><br />2. <strong>Conditions Treated</strong>: BoNT procedures can be utilized to address various conditions such as dystonia (generalized, focal, cervical dystonia, blepharospasm, hemifacial spasm, and oromandibular dystonia), upper motor neuron syndromes, bruxism, sialorrhea, and congenital torticollis.<br /><br />3. <strong>Principles for BoNT Procedures</strong>:<br />   - Identifying muscles contributing to pathological postures.<br />   - Avoiding compensatory muscles.<br />   - Precise placement of BoNT to avoid adverse events and maximize efficacy.<br />   - Using US to enhance targeting accuracy by providing real-time visualization of muscle thickness, location, and safe paths for needle insertion.<br /><br />4. <strong>US Guidance</strong>: Ultrasound is highlighted as an essential tool:<br />   - It aids in quickly and accurately identifying muscle targets.<br />   - Tracks needle placement, ensuring precise delivery of BoNT.<br />   - Avoids non-targeted structures such as vessels and nerves, reducing risks.<br />   - Can be combined with EMG for enhanced procedural accuracy.<br /><br />5. <strong>Practical Application</strong>: The presentation includes detailed guidelines on US identification of key muscles and structures, muscle selection caveats for specific movements and postures, and recommendations for accurate descriptions of patient postures. It emphasizes the importance of understanding both sustained and dynamic postures in developing effective treatment plans.<br /><br />Dr. Alter concludes by underscoring the importance of recognizing the patterns of head and neck movements and leveraging the advantages of US in conjunction with other guidance methods (like EMG), ensuring precise and safe BoNT injections for better patient outcomes.

Keywords

Head and Neck Anatomy

Botox Chemodenervation

Functional Anatomy

Ultrasound Guidance

BoNT Procedures

Dystonia Treatment

Muscle Identification

Needle Placement

Patient Postures

AANEM Annual Meeting