0:00Hi, Dr. Gina here. Today this video is going to be about ultrasound guided bottulum toxin injections of the DAO, the depressor angulys. Why this muscle?
0:1313 secondsbecause it has a very high anatomical variability and blind injections can risk diffusion into the depressor lab
0:2222 secondsinferior and even the orbicularis giving you complications like speech
0:2828 secondsalterations or smile asymmetries. So it's very important for us to be very precise. The first step would be to
0:3737 secondsidentify the muscle and for that I'll be using the indescatic parameters the chin and jaw.
0:4646 secondsWe will be holding the probe very slightly
0:5353 secondson the chin of the patient. So the DAO is a hypocoic triangular muscle that
1:001 minutegoes from the mandible to the mouth corner. By asking the patient to do a downwards movement of the mouth, it
1:081 minute, 8 secondsbecomes easier for you to identify the muscle. So can you please do that movement? Yes. Relax.
1:171 minute, 17 secondsDo it again. Okay. I identify the muscle right there. So the second step would be insert the needle on the plane of the
1:261 minute, 26 secondsmid belly of the muscle. So again move the muscle.
1:351 minute, 35 secondsOkay. I turn on the needle enhancer so we can see the needle very well. And
1:421 minute, 42 secondswhile you inject a very low dosage you can see the expansion of the muscle under the ultrasound. And that's it for
1:501 minute, 50 secondsthe procedure. It's very simple and fast. And doing it this way, you are going to prevent the high risk of
1:591 minute, 59 secondssuperficially injecting the orbicularis or muscle or even the depressor lab inferior which would give you a speech
2:072 minutes, 7 secondsalterations and smile asymmetries. This is how we are going to do a very safe injection for your patients. That would
2:162 minutes, 16 secondsbe a treatment h mostly for the marionette line. I hope you enjoyed this video. Hope to see you soon. Bye-bye.