Surgical and Radiologic Anatomy

, Volume 39, Issue 3, pp 263–269 | Cite as

Anatomical recommendations for safe botulinum toxin injection into temporalis muscle: a simplified reproducible approach

  • Won-Kang Lee
  • Jung-Hee Bae
  • Kyung-Seok Hu
  • Takafumi Kato
  • Seong-Taek Kim
Original Article



The objective of this study was to simplify the anatomically safe and reproducible approach for BoNT injection and to generate a detailed topographic map of the important anatomical structures of the temporal region by dividing the temporalis into nine equally sized compartments.


Nineteen sides of temporalis muscle were used. The topographies of the superficial temporal artery, middle temporal vein, temporalis tendon, and the temporalis muscle were evaluated. Also evaluated was the postural relations among the foregoing anatomical structures in the temporalis muscle, pivoted upon a total of nine compartments.


The temporalis above the zygomatic arch exhibited an oblique quadrangular shape with rounded upper right and left corners. The distance between the anterior and posterior margins of the temporalis muscle was equal to the width of the temporalis rectangle, and the distance between the reference line and the superior temporalis margin was equal to its height. The mean ratio of width to height was 5:4.


We recommend compartments Am, Mu, and Pm (coordinates of the rectangular outline) as areas in the temporal region for BoNT injection, because using these sites will avoid large blood vessels and tendons, thus improving the safety and reproducibility of the injection.


Temporalis muscle Botulinum toxin Bruxism Temporal region Injection point 


Compliance with ethical standards

Conflict of interest

All authors have no financial and private relationships with commercial and political organization or people that could improperly influence this research.


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Copyright information

© Springer-Verlag France 2016

Authors and Affiliations

  • Won-Kang Lee
    • 1
  • Jung-Hee Bae
    • 2
  • Kyung-Seok Hu
    • 2
  • Takafumi Kato
    • 3
  • Seong-Taek Kim
    • 1
    • 2
  1. 1.Department of Orofacial Pain and Oral MedicineYonsei University College of DentistrySeoulSouth Korea
  2. 2.Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research CenterYonsei University College of DentistrySeoulSouth Korea
  3. 3.Department of Oral Anatomy and NeurobiologyOsaka University Graduate School of DentistryOsakaJapan

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