Long-term sequelae treatment of peripheral facial paralysis with botulinum toxin type A: Repartition and kinetics of doses used

Risoud, M.; Aljudaibi, N.; Duquennoy-Martinot, V.; Guerreschi, P.

doi:10.1016/j.anplas.2015.04.002

Cited by 13 publications

(8 citation statements)

References 17 publications

(19 reference statements)

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“…A core group of 6 muscles, the corrugator, orbicularis oculi superioris and orbicularis oculi inferioris, mentalis, risorius, and platysma, were consistently treated, and these muscles, which provide a large degree of facial muscle mass, were targeted more consistently and at increased doses over time. This is contrary to the results of Risoud and colleagues, who initially increased dosing after the first injection, with decreased dosing on subsequent treatments. We not only increased individual muscle dose and frequency but also found that higher doses resulted in improved SAQ outcomes; therefore, the doses were increased as tolerated.…”

Section: Discussioncontrasting

confidence: 99%

Treatment Patterns and Outcomes in Botulinum Therapy for Patients With Facial Synkinesis

Shinn

Nwabueze

et al. 2019

JAMA Facial Plast Surg

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In the last decade, there has been a significant increase in the number of practitioners administering botulinum toxin for facial synkinesis. However, there are few resources available to guide treatment patterns, and little is known about how these patterns are associated with functional outcomes and quality of life.OBJECTIVE To evaluate botulinum treatment patterns, including the dosing and frequency of muscle targeting, for treatment of facial synkinesis and to quantify patient outcomes. DESIGN, SETTING, AND PARTICIPANTSThis prospective cohort study of 99 patients treated for facial synkinesis was conducted from January 2016 through December 2018 at the Vanderbilt Bill Wilkerson Center in Nashville, Tennessee, a tertiary referral center.INTERVENTION Onabotulinum toxin A treatment of facial synkinesis. MAIN OUTCOMES AND MEASURES Patient-reported outcomes on the Synkinesis AssessmentQuestionnaire and botulinum treatment patterns, including the dosages and frequency of injection for each facial muscle, were compared at the initiation of treatment and at the end of recorded treatment. RESULTSIn total, 99 patients (80 female patients [81%]) underwent botulinum injections for treatment of facial synkinesis. The median (interquartile range) age was 54.0 (43.5-61.5) years, and the median (interquartile range) follow-up was 27.1 (8.9-59.7) months. Most patients underwent injections after receiving a diagnosis of Bell palsy (41 patients, 41%) or after resection of vestibular schwannoma (36 patients [36%]). The patients received a total of 441 treatment injections, and 369 pretreatment and posttreatment Synkinesis Assessment Questionnaire scores were analyzed. The mean botulinum dose was 2 to 3 U for each facial muscle and 9 to 10 U for the platysma muscle. The dose increased over time for the majority of all muscles, with steady state achieved after a median of 3 treatments (interquartile range, 2-3). Linear regression analysis for cluster data of the mean total questionnaire score difference was −14.2 (95% CI, −17.0 to −11.5; P < .001). There was a significant association of postinjection questionnaire score with younger patients, female sex, total dose, and synkinesis severity. Oculo-oral synkinesis may respond more to treatment compared with oro-ocular synkinesis.CONCLUSION AND RELEVANCE Patients with facial synkinesis responded significantly to botulinum treatment. Treatment began with 6 core facial muscles that were injected during most treatment sessions, and dosages increased after the first injection until steady state was achieved. Those with a greater degree of morbidity, younger patients, and females showed significant improvement, and the larger the dose administered, the greater the response. Oculo-oral synkinesis may be more responsive than oro-ocular synkinesis.LEVEL OF EVIDENCE 3.

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Section: Discussioncontrasting

confidence: 99%

Treatment Patterns and Outcomes in Botulinum Therapy for Patients With Facial Synkinesis

Shinn

Nwabueze

et al. 2019

JAMA Facial Plast Surg

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“…O intervalo de tempo entre as sessões variou-se de seis semanas (Rutzen, et al, 2016), três meses (Alipour, et al, 2021) e quatro meses (Akulov, et al, 2017). Choi, et al (2013), Risoud, et al (2015, Bennis, Duquennoy-Martinot e Guerresch (2016), Akulov, et al (2017), Shinn et al (2019), em seus estudos seguiram o protocolo de tratamento associando a injeção da toxina botulínica tanto no lado paralisado para reduzir espasmos e melhorar a força, quanto do lado não paralisado para diminuir hiperatividade muscular e reduzir assimetria. Segundo estes autores, a combinação de tratamento em ambos os lados possui maior eficácia sendo considerado o melhor padrão de tratamento.…”

Section: Discussionunclassified

A utilização da toxina botulínica no tratamento da paralisia facial periférica

Andalécio

Andrade

Lima

et al. 2021

RSD

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A Paralisia Facial Periférica (PFP) é um estado de paralisação ou enfraquecimento dos músculos da face que causam limitações motoras e estéticas ao paciente com esta condição. Um meio de tratamento para a PFP que vem ganhando destaque é a utilização de toxina botulínica no lado contralateral ao acometido pela condição. Esta toxina é coletada através dos esporos da bactéria Clostridium botulinum, e atua inibindo a liberação de acetilcolina na junção neuromuscular, diminuindo hiperfunção muscular e devolvendo simetria a face do paciente. Portanto, este estudo tem como objetivo alcançar o conhecimento do melhor protocolo de aplicação da toxina na paralisia, além de qual sorotipo usar e a capacidade de melhoria na qualidade de vida do paciente. O estudo consta com uma revisão integrativa de caráter básico, qualitativa, descritiva-explicativa com base nas principais plataformas de pesquisa buscando os termos paralisia facial e toxina botulínica. Foram incluídos artigos no intervalo de tempo de 2011 a 2021 na língua inglesa e a busca resultou em 17 artigos. Em todos os artigos revisados o sorotipo A da toxina botulínica foi o único utilizado para o tratamento, a quantidade de unidades biológicas (UI) e o protocolo foi individualizado para cada paciente isentando de um padrão. A qualidade de vida dos pacientes foi devolvida após se obter melhora na simetria facial e com isso aumento na autoestima além de principalmente, devolver a capacidade de realizar ações musculares coordenadas. Portanto, pode-se concluir que o tratamento da PFP com toxina botulínica é altamente benéfico aos pacientes.

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“…In 30% of cases, patients possess sequelae such as hemifacial spasm, synkinesias, and spasticity [ 2 , 3 ]. Patients with non-idiopathic facial paralysis, particularly secondary to surgery, may also possess this type of complication [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin Injections to Manage Sequelae of Peripheral Facial Palsy

Carré,

Amar,

Tankéré

et al. 2024

Toxins

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Long-standing facial palsy sequelae cause functional, aesthetic, and psychological problems in patients. Botulinum toxin is an effective way to manage them, but no standardized recommendations exist. Through this non-systematic review, we aimed to guide any practitioner willing to master the ins and outs of this activity. We reviewed the existing literature and completed, with our experience as a reference center, different strategies of botulinum toxin injections used in facial palsy patients, including history, physiopathology, facial analysis, dosages, injection sites, and techniques, as well as time intervals between injections. The reader will find all the theorical information needed to best guide injections according to the patient’s complaint, which is the most important information to consider.

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Long-term sequelae treatment of peripheral facial paralysis with botulinum toxin type A: Repartition and kinetics of doses used

Cited by 13 publications

References 17 publications

Treatment Patterns and Outcomes in Botulinum Therapy for Patients With Facial Synkinesis

Treatment Patterns and Outcomes in Botulinum Therapy for Patients With Facial Synkinesis

A utilização da toxina botulínica no tratamento da paralisia facial periférica

Botulinum Toxin Injections to Manage Sequelae of Peripheral Facial Palsy

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