Ideal Injection Points for Botulinum Neurotoxin for Pectoralis Minor Syndrome: A Cadaveric Study

Area of Science:

• Anatomy
• Neuroscience
• Medical Treatment

Background:

• Pectoralis Minor Syndrome (PMS) involves neurovascular bundle compression.
• Botulinum neurotoxin (BoNT) injections are a potential PMS treatment.
• Accurate injection site localization is crucial for BoNT efficacy in PMS.

Purpose of the Study:

• To identify optimal injection sites for Botulinum neurotoxin (BoNT) in Pectoralis Minor Syndrome (PMS) treatment.
• To determine the origin and intramuscular arborization of the pectoralis minor muscle (Pm).

Main Methods:

• Utilized manual dissection and Sihler's nerve staining on human cadavers.
• Performed blind dye injections to validate anatomical findings.
• Analyzed the origin and neural arborization patterns of the pectoralis minor muscle (Pm).

Main Results:

• The pectoralis minor muscle (Pm) originates near an oblique line through the suprasternal notch.
• Most neural arborization occurs within the proximal three-fourths of the Pm.
• Optimal injection sites identified at the intersection of the oblique line with the second and third ribs.

Conclusions:

• Proposed targeting the arborized region within the proximal three-fourths (C region) of the Pm for BoNT injections.
• Findings aim to enhance the safety and effectiveness of BoNT treatments for PMS.
• Provides anatomical guidance for clinicians performing BoNT injections for Pectoralis Minor Syndrome.