Document Detail

Botulinum toxin injection of both sides of the face to treat post-paralytic facial synkinesis.
MedLine Citation:
PMID:  23683725     Owner:  NLM     Status:  Publisher    
OBJECTIVE: An attempt has been made to produce a new 'balance' in facial dynamics between a paralysed and a non-paralysed face with reduction of synkinesis, by concomitant injection of botulinum toxin A (BTX-A) on both sides in patients with long-lasting facial sequelae. STUDY DESIGN: Prospective clinical study. SETTING: University hospital. SUBJECTS AND METHODS: Forty-two consecutive patients who recovered partially from facial nerve paralysis were enrolled for this study. The amount injected per site of the paralysed side with synkinesis varied from 1.5 to 2.5 U, and the total dose used per patient was 10-26 U (mean 17.12 ± 5.3 U). That of the non-paralysed side with muscular hypertrophy varied from 2.5 to 5 U, and the total dose used per patient was 35-72 U (mean 52.6 ± 9.7 U). All patients had been evaluated by the Sunnybrook (SB) facial nerve grading systems and developed dynamic facial asymmetry ratio. RESULTS: After administration of injection of BTX-A on both sides of the face, relief of facial synkinesis and enhancement of facial symmetry were observed in all patients. Before the injection, the patients showed an SB score of 38.8 ± 10.68. After the injection, changes of synkinesis and symmetry score were 7.9 ± 1.81 and 8.4 ± 3.25, respectively, resulting in a 58.4 ± 12.46 score at the last evaluation. Before the administration, the mean ± standard deviation (SD) value of dynamic facial asymmetry was 0.83 ± 0.06 and it was increased significantly to 0.90 ± 0.05 1 month after administration. CONCLUSION: After BTX-A injection on both sides for synkinesis and contralateral hypertrophy, the patients showed significant suppression of the synkinesis and improvement of facial symmetry with resulting elevated quality of life, social interaction, personal appearance and food intake.
Ki Hoon Choi; Seung Hwan Rho; Jun Myung Lee; Ju Hyun Jeon; Si Young Park; Jin Kim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-5-15
Journal Detail:
Title:  Journal of plastic, reconstructive & aesthetic surgery : JPRAS     Volume:  -     ISSN:  1878-0539     ISO Abbreviation:  J Plast Reconstr Aesthet Surg     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-5-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264239     Medline TA:  J Plast Reconstr Aesthet Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Department of Otorhinolaryngology, Inje University College of Medicine, Ilsan Paik Hospital, 2240 Daehwa-dong, IlsanSeo-gu, Goyang-si, Gyeonggi-do, Republic of Korea.
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