Injection into the Longus Colli Muscle via the Thyroid Gland

Tyślerowicz, Małgorzata; Jost, Wolfgang H.

doi:10.5334/tohm.489

Cited by 8 publications

(13 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We are more successful now in pinpointing injections, and in reaching muscles which we could not target earlier [22][23][24][25]. As a case in point, we should mention OCI (obliquus capitis inferior) which plays an essential role in the most frequent form of CD and which used to be only rarely targeted for injection [22,26].…”

Section: Injection and The Use Of Emg And Usmentioning

confidence: 97%

“…US outlines the anatomical structures more exactly [21], while EMG portrays function better. The two methods are thus not substitutes for one another, but rather complement each other (visibility and function) [5,22].…”

Section: Injection and The Use Of Emg And Usmentioning

confidence: 99%

“…trapezius), meaning that a precise injection can only be guaranteed with the help of US. This is the only way to offer assurance that BoNT is applied precisely where we intend it [21][22][23].…”

Section: Injection and The Use Of Emg And Usmentioning

confidence: 99%

See 2 more Smart Citations

Botulinum neurotoxin in cervical dystonia revisited — recent advances and unanswered questions

Sławek

Jost

2021

Neurol Neurochir Pol.

Self Cite

View full text Add to dashboard Cite

Cervical dystonia (CD) usually presents a complex pattern of head/neck movements accompanied by tremor, myoclonic jerks and a wide spectrum of non-motor disturbances such as pain, depression, anxiety, and sleep problems. This is the most challenging indication for botulinum neurotoxin (BoNT) treatment. It can offer significant improvement, but it can be difficult after the first injection. Thorough examination and identification of the proper CD pattern, the identification of the muscles responsible, and adjusting doses given precisely under ultrasound and/or electromyographic guidance seem to be the key success modifiers. Nevertheless, this is a lifelong treatment and should be planned and conducted carefully to avoid failures and drop outs. The aim of this paper was to examine the current concepts in terms of anatomy, physiology and CD patterns (Col-Cap concept) as well as the proper dosages and any possible obstacles impeding successful treatment.

show abstract

Section: Injection and The Use Of Emg And Usmentioning

confidence: 97%

Section: Injection and The Use Of Emg And Usmentioning

confidence: 99%

See 1 more Smart Citation

Botulinum neurotoxin in cervical dystonia revisited — recent advances and unanswered questions

Sławek

Jost

2021

Neurol Neurochir Pol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Ultrasound was also proposed as a guidance technique, which allows real-time visualization of the trajectory of an EMG needle, as it is impossible to verify needle positioning in the proper muscle without imaging which may influence treatment outcomes [18]. It has also been reported that the needle traversed the tissue of a thyroid gland without any consequences [16,19]. While on one hand, it may be indeed an attractive addition to guide the procedure, particularly, in a lateral approach to LCo when the needle should be advanced between the anterior scalene muscle and the carotid sheath, which creates a risk of damaging the phrenic nerve, brachial plexus, and even the structures of the carotid sheath, on the other hand, ultrasound guidance demands more human and technical recourses as well as additional costs.…”

Section: Injection Technique and Anatomical Considerationsmentioning

confidence: 99%

A methodological approach for botulinum neurotoxin injections to the longus colli muscle in dystonic anterocollis: A case series of 4 patients and a literature review

Seliverstov

Arestov

Klyushnikov

et al. 2020

Journal of Clinical Neuroscience

View full text Add to dashboard Cite

We review the current approaches and their feasibility to treat dystonic anterocollis by injecting longus colli muscle (LCo) with botulinum neurotoxin (BoNT) as well as present our personal experiences in this field compared with the findings from previously published studies. First, we searched the PubMed database for the publications reporting patients who received LCo injections for anterocollis; we also thoroughly examined the references included in each of the found publications. Second, we present and analyze our own experiences in injecting LCo under EMG guidance in patients with dystonic anterocollis due to heredodegenerative disorders. We found 11 publications describing administration of LCo injections for the treatment of dystonic anterocollis in a total of 28 patients with primary dystonia aged between 21 and 80 years. The mean age of our patients was 44.8 years with the mean anterocollis duration being 15 months. OnabotulinumtoxinA in a dose of up to 35 U per LCo muscle was not associated with the development of transient dysphagia. The mean percentage of patient satisfaction was 36.3%, and the mean duration of the beneficial effect was 2.5 months. All patients agreed to receive a repeat injection. We provide a set of empirically based suggestions on the current use of BoNT injections to LCo for managing anterocollis in outpatient clinics, including pretreatment work-up, injection technique, and dose range.

show abstract

“…The injection of the LCo has been regarded as difficult and potentially dangerous [6] and so it is not routinely offered in the clinical setting. There are sporadic case reports [8,9,10] and a short series in the literature describing injection of the longus colli under fluoroscopy [7], CT [8], or ultrasound [9,10] guidance, sometimes under sedation [7]. The majority of descriptions [7,8,9] describe a lateral approach taking the injector close to the carotid sheath.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Study to Validate the Anterior Cervical Approach to the Longus Colli Muscle Using Electromyography Control Alone

Hicklin

Koçer²,

Watson

et al. 2020

Tremor and Other Hyperkinetic Movements

View full text Add to dashboard Cite

Background: One of the main difficulties in the treatment of dystonic anterocollis is the injection of the deep flexor muscles of the neck such as Longus Colli (LCo). The injection of the LCo has been regarded as difficult and potentially dangerous; since we published our anterior median approach, a number of questions about the precision and the safety of our technique have been raised by colleagues. Methods: 7 patients with anterocollis were injected, using our injection technique and when the needle was deemed to be in place, we used the ultrasound probe to determine what the needle had passed through, the depth of the tip of the needle and if the identified muscle was indeed LCo. Results: On the ultrasound section the LCo muscle is between 24 and 28 mm deep in the patients examined in this study. The location of the needle was confirmed by ultrasound and in most cases the needle was placed in the right axis but sometimes not deep enough. The EMG control made it possible to correct the depth in all cases. In most of the injections the needle traversed the thyroid. No acute incident occurred by this route of injection. Injections were performed between 22 and 28 mm deep. Discussion: From this study and based on a review of complications over 9 years experience with injecting LCo under EMG control using an anterior approach, we conclude that this technique is precise, safe and well tolerated. Summary (Highlights): The injection of the Longus Coli muscle for anterocollis has been regarded as difficult and potentially dangerous. This study showed, using ultrasound to determine the needle trajectory, that the anterior approach using EMG control is a precise, safe and well tolerated technique.

show abstract

Injection into the Longus Colli Muscle via the Thyroid Gland

Cited by 8 publications

References 15 publications

Botulinum neurotoxin in cervical dystonia revisited — recent advances and unanswered questions

Botulinum neurotoxin in cervical dystonia revisited — recent advances and unanswered questions

A methodological approach for botulinum neurotoxin injections to the longus colli muscle in dystonic anterocollis: A case series of 4 patients and a literature review

Ultrasound Study to Validate the Anterior Cervical Approach to the Longus Colli Muscle Using Electromyography Control Alone

Contact Info

Product

Resources

About