Document Detail


Botulinum toxin in the treatment of post-radiosurgical neck contracture in head and neck cancer: A novel approach.
MedLine Citation:
PMID:  22104582     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Neck pain affects a third of patients following head-and-neck cancer treatment, whether by radiation therapy or surgery. It is a disabling condition and the associated muscle contractures impair cervical motion. Type-A botulinum toxin is an analgesic and muscle relaxant, able to improve patients' quality of life. We here report our experience with botulinum toxin in post-radiosurgical neck contracture. PATIENTS AND METHODS: A single-center pilot study was run from January 2007 to July 2008, respecting the Declaration of Helsinki. All patients in complete remission from head-and-neck cancer with post-radiosurgical neck contracture impairing neck motion were included. Pain and functional impairment were assessed on a neck-function disability scale before and 1 month after botulinum toxin injection. Efficacy duration was measured. Complications at the injection site or related to drug diffusion were investigated. RESULTS: Nine consecutive patients (six male, three female; mean age, 61 years [range, 52-73 years]) were included. In six patients, the sternocleidomastoid muscle was injected and the muscular pedicle of a pectoralis major flap in three. Mean cervical disability score fell significantly from 33 to 23 (P=0.01). There were no complications. Efficacy was seen at a mean 6 days, and analgesia and muscle relaxation lasted for a mean 19 days. CONCLUSION: In post-radiosurgical neck contracture, botulinum toxin injection is a simple and easy procedure able to improve neck motion and reduce neck pain in head-and-neck cancer patients. A phase-II prospective study to determine injection sites and dosage should help bear out these preliminary findings.
Authors:
C-A Bach; I Wagner; X Lachiver; B Baujat; F Chabolle
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-18
Journal Detail:
Title:  European annals of otorhinolaryngology, head and neck diseases     Volume:  -     ISSN:  1879-7296     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101531465     Medline TA:  Eur Ann Otorhinolaryngol Head Neck Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Masson SAS. All rights reserved.
Affiliation:
Service de chirurgie ORL et cervicofaciale, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; UFR de médecine Paris Ouest Saint-Quentin en Yvelines, université de Versailles-Saint-Quentin en Yvelines, 9, boulevard d'Alembert, 78280 Guyancourt, France.
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