Electrophysiologic change and facial contour following botulinum toxin a injection in square faces
Electrophysiologic change and facial contour following botulinum toxin a injection in square faces
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DOI：
10.1097/01.prs.0000271068.71399.ae
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发表时间：
2007-09-01
影响因子：
3.6
通讯作者：
Lee, Se Il
中科院分区：
文献类型：
--
作者：
Lee, Choong Jae;Kim, Sun Goo;Lee, Se Il
背景：本研究旨在评价A型肉毒毒素注射于宽下方面(方脸)前后的面型及咬、颞肌的电生理变化。方法：对10例方面肌肥大患者进行A型肉毒毒素注射治疗。治疗前及治疗后1、3、5、7、9、12个月分别进行面肌肌电检查，客观评价治疗前后面部轮廓的变化，包括体格测量、头影测量和临床照片，并评价咬肌和颞肌的功能。结果：通过体格测量和头影测量，治疗后3个月面部下部轮廓最大幅度下降(平均下降6.6 mm和7.5 mm)，至治疗后12个月缓慢增加。治疗后1个月左右咬肌最大波幅均降至最低值，此后持续升高。在所有随访时间点，通过物理测量减少面部下部轮廓和左侧咬肌肌电研究，均有统计学意义上的差异。结论：A型肉毒杆菌毒素注射后，面肌肌电最大波幅的最低值与最大临床疗效之间有2个月的间隔，咬肌功能的恢复与临床疗效的减退有相似之处。A型肉毒毒素的临床疗效在治疗后的12个月内持续进行体格测量，作者认为A型肉毒毒素的这种超乎预期的长期效应可以解释为肌肉功能的未完全恢复。
Background: This study was proposed to evaluate the facial contour and electrophysiologic changes of the masseter and temporalis muscles before and after botulinum toxin A injection in the wide lower face (square face).Methods: The botulinum toxin A injections were performed on 10 patients for the treatment of square face with masseter hypertrophy. To obtain an objective evaluation of the change in the facial contour, physical measurements, cephalometry, and clinical photographs were taken; and for evaluation of the function of the masseter and temporalis muscles, electromyographic studies were performed before and 1, 3, 5, 7, 9, and 12 months after treatment.Results: By physical measurements and cephalometry, the maximal reduction in lower facial contour (mean reduction, 6.6 mm by physical measurements and 7.5 mm by cephalometry) was observed 3 months after the injection, and increased slowly until 12 months after treatment. The maximal amplitude of the right and left masseter muscles decreased to the lowest value I month after treatment, with continuous increase being observed thereafter. There were statistically significant differences at all of the follow-up time points in reduction of lower facial contour by physical measurements and in electromyographic studies of the left masseter muscles. There was no hypertrophy of the temporalis muscle to compensate for the atrophy of the masseter muscles.Conclusions: In this study, there was a 2-month interval between the lowest value of the maximal amplitude of the surface electromyography and the maximal clinical effects following botulinum toxin A injection, and there was similarity between the recovery of the masseter function and the diminution of the clinical effect. The clinical effect of botulinum toxin A persisted for 12 months after treatment on physical measurements, and the authors felt that this long-lasting effect of botulinum toxin A beyond expectation could be explained by incomplete recovery of muscle function.