Section 1 of 6
Define the problem and the evidence
A technique report is not an efficacy trial.
Risks and benefits
Intended benefit
Define the functional problem, such as restricted opening, before considering this deep muscle. The cited technique reports and mixed-muscle trial do not establish an isolated medial-pterygoid injection benefit or a reliable magnitude of improvement.
Risks and tradeoffs
Discuss pain, bleeding, infection, injury to nearby structures and unwanted weakness. With botulinum toxin, include dysphagia (difficulty swallowing) and speech or breathing difficulties; new swallowing or breathing symptoms need urgent assessment.
Make the decision together
Reconsider competing causes and conservative options. Establish target identity and a usable imaging window before choosing an access plan. Monitor mouth opening, chewing, pain and swallowing against baseline.