IncobotulinumtoxinA treatment resulted in significant improvements in facial symmetry in patients with facial nerve injury following neurosurgical interventions. Treatment was effective for the correction of the compensatory hyperactivity of mimic muscles on the unaffected side that develops in the acute period of facial nerve palsy, and for the correction of synkinesis in the affected side that develops in the long-term period. Appropriate dosing and patient education to perform exercises to restore mimic muscle function should be considered in multimodal treatment.

Surgical treatment of posterior cranial fossa and cerebellopontine angle tumors is associated with a risk of facial nerve dysfunction. The causes for facial muscle paresis include nerve compression by the tumor, destruction of the nerve structure by the tumor growing from nerve fibers, nerve injury during surgical removal of the tumor, etc. The first 3 months after facial nerve injury are a potential therapeutic window for the use of botulinum toxin type A (BTA). During this period, the drug is introduced both in the healthy side to improve the facial symmetry at rest and during mimetic movements and in the affected side to induce drug-induced ptosis. Post-paralytic syndrome develops 4-6 months after facial nerve injury. At this stage, administration of BTA is also an effective procedure; in this case, drug injections are performed on the affected side at small doses and symmetrically on the healthy side at doses doubling those for the affected side. BTA injections are mandatory in complex treatment of facial muscle paralysis.

A.I. Burnazyan Federal Medical and Biological Center, FMBA of Russia; 23 Marshala Novikova St., Moscow 123098, Russia; 3

No abstract

No abstract

No abstract

The article concerns on the problems of vascular comorbidity epidemiology and pathophysiological aspects of heart disease, which became a leading etiopathologic factor of cerebral infarctions and hemorrhages. The relationship between coronary artery disease (CAD), atrial fibrillation, hypertension and cerebral infarction types is emphasized.Aim. To analyze the role of comorbidity, attributable to cardio-vascular pathology in the initiation, course, clinical features and outcomes of cerebral infarction.Material and methods. We performed a prospective study, including 1072 patients with stroke, attributable to various cardiovascular pathology, evaluated the influence of vascular comorbidity of variable degree on the course and outcomes at an inpatient stage and at follow-up.Results. We demonstrated a negative influence of CAD, atrial fibrillation and postinfarction cardiosclerosis on the incidence of cerebral infarction, unfavorable course of the disease and functional outcomes at inpatient stage. The combination of vascular comorbidity resulted in an increased mortality in post-stroke period during 6 years of follow-up.Conclusion. Epidemiology of vascular comorbidity, its role in cerebrovascular accidents in patients with cardiac pathology justifies the need of active realization of contemporary multidisciplinary prevention programs, prolonged instrumental monitoring and implementation of energy deficiency correction therapy in comprehensive treatment programs.

Objective: To compare the results of chronic anal fissure treatment with 10 IU and 40 IU botulinum toxin type A. Patients and methods: 56 patients were enrolled in case-control study divided into 2 groups consistent by the main clinical criteria. 28 patients in the study group had fissure excision in combination with 10 IU botulinum toxin type A (Xeomin) injection into internal anal sphincter, while 28 patients in control group received 40 IU product injections. Results: No statistically significant results in the pain assessment during the day and after bowel movement were obtained (p=0.41 and p=0.93, respectively). The groups were comparable by the frequency of complications such as transient anal incontinence, perianal skin hematoma, acute urinary retention (p>0.05). Complications such as thrombosis of external hemorrhoids and chronic non-healing wounds were most common in the study group (p=0.43 and p=0.0005, respectively). The product dose increase to 40 IU has a more significant effect on the functional treatment results (p=0.0053 and p=0.0002, respectively) and increases the odds for postoperative wound epithelialization 15-fold (p=0.01). Conclusion: 40 IU Botulinum toxin type A shows improvement in the treatment of chronic anal fissure without any increased risk of postoperative complications.