Ultrasound Guidance for Head
and Neck Injections
Katharine E Alter MD
MWPH
NIH
US Guidance for Head and Neck
Injections
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Muscle Over-Activity
• Sialorrhea
– UMN conditions
Cervical dystonia
• CP
Oromandibular dystonia
• TBI
UMN conditions
• Others
– ALS
Bruxism
– TMJ
• Hemifacial spasm
– Parkinson’s
• Sialocoele
Anterior Neck
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1. digastric posterior
belly
2. Sternhyoid
3. omohyoid superior
4. Omohyoid inferior
5. sternohyoid
6. Sternothyroid
7. Levator Scapulae
8. Scalenes
9. Trapezius
10. SCM
Sternocleidomastoid
SCM
Transverse Localization
Picture:SCM Tv Localiz IMG_0475.jpg
Longitudinal , Out of Plane
Injection
Picture:: SCM LA inject photo
Sternocleidomastiod (SCM)
Transverse View Doppler
SCM, Injection
Picture Link:SCM Gorin.PNG
Video Link: SCM GORIN Linj 2.mpg
SCM
Transverse View, Out of Plane
Needle Inserted in Carotid
Video Link SCM Nee inserted into carotid.mpg
Picture Link: SCM Needle inserted into carotid.png
SCM
Longitudinal
Picture Link SCM LA OP SC.png
Longitudinal, Out of Plane
Injection
Video Link: SCM LA OP SC.WMV
Splenius Capitus
Splenius Capitis
Transverse
Picture:Splenius inj 0236.jpg
Oblique, Transverse
Picture: Splenius Localiz
Splenius Capitus
Picture:Splen cap Tv OP MH2
Picture: Splen Cap Tv OP MH1
Splenius Capitus
Transverse
Picture Link: Splenius Capitus Tv.jpg
Transverse, Dystonic Movements
Video Link: Splen Cap Tv with dystonia.wmv
Splenius Capitus
Long axis view
Long axis isolation,
Out of plane injection
Video Link: Splenius Capitus LA Scan Inj 1.wmv
Picture Link: Splenius LA Edited.png
Scalene Complex
Scalene Complex
Longitudinal
Picture: Scalenes LA IMG_0479.jpg
Transverse, Middle, Post Scalene
Picture:Scalene Middle PC132118.JPG
Scalene Complex: Transverse
Scalenes BP Tv localiz 4 31.mpg
Video Link: Scalenes Localiz Tv OP Inj NS
Scalenes, Anterior, Middle
Localization, Transverse
Video:Scalene ant mid Localiz Tv Kea.wmv
Scalenes, Transverse
Scalene Triangle
Anterior, middle
Video Link: Scalene Tv Doppler Bplx.wmv
Levator Scapulae
Levator Scapulae
Picture Link:Lev Scap Inj Ant photo.jpg
Picture:Trap Middle Tv OP MH2.JPG
Levator Scapulae
Posterior at Scapular Insertion
Injection Out of Plane
Trapezius
Levator Sc.
Masseter
Indication: Bruxism/Jaw
Closing Dystonia
Picture:
Transverse
Picture: Masseter Tv PC262466.JPG
Masseter
Transverse
Transverse view,
Dystonic tremor
Video Link:Masseter Tv Dystonic Mvt
OP AE .wmv
Salivary Gland
Parotid
Parotid
Salivary Gland, Parotid
Parotid: L Posterior R Anterior
Parotid Doppler, post injection
Salivary Gland
Submandibular
Submandibular
Submandibular Gland
Localization, Child