Quezada-Gaon Natacha, Wortsman Ximena, Peñaloza Osvaldo, Carrasco Juan Eduardo
Department of Dermatology, Faculty of Medicine, Pontifical Catholic University, Santiago, Chile.
Department of Radiology and Department of Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Clinica Servet, Faculty of Medicine, University of Chile, Santiago, Chile.
J Cosmet Dermatol. 2016 Sep;15(3):238-44. doi: 10.1111/jocd.12208. Epub 2016 Jan 22.
Botulinum toxin type A has been used for treating the hypertrophy of the masseter muscles and its cosmetic effects. Ultrasound is increasingly used in dermatology, along with the guidance of mini-invasive procedures.
To evaluate the role of ultrasound for guiding the application of Botulinum A toxin in patients with cosmetic alterations due to bruxism, correlate the clinical landmarks with the ultrasound findings, and study the effect on the symptoms, cosmetics, and quality of life.
PATIENTS/METHODS: Twenty individuals with bruxism and cosmetic alterations underwent an ultrasound-guided injection of Botulinum toxin type A in each masseter muscle. Clinical and ultrasound marking of the procedure was compared. Clinical and sonographic evaluation was performed at the time of injection and 3 months later. Ten normal individuals underwent ultrasound of the masseter muscles as a control group.
Up to 65% of individuals showed anatomical variants of the salivary glands. The method for clinically marking the skin showed a frequently erroneous location of the anterior point (up to 40% of cases) that was proven by ultrasound to be out of the muscle. In 20% of cases, ultrasound showed that the needle should be longer to enter the muscle. After injection, most of the patients demonstrated a decrease of the symptoms and cosmetic and quality of life improvements.
Ultrasound can be a potent tool for guiding the injection of Botulinum toxin into the masseter muscles. It may contribute to a more personalized procedure, better cosmetic results, and help to avoid potential complications.
A型肉毒杆菌毒素已被用于治疗咬肌肥大及其美容效果。超声在皮肤病学中的应用越来越广泛，同时也用于微创操作的引导。
评估超声在引导A型肉毒杆菌毒素应用于磨牙症所致美容改变患者中的作用，将临床标志与超声检查结果相关联，并研究其对症状、美容效果和生活质量的影响。
患者/方法：20名患有磨牙症和美容改变的个体在每侧咬肌接受了超声引导下的A型肉毒杆菌毒素注射。比较了该操作的临床和超声标记情况。在注射时和3个月后进行了临床和超声评估。10名正常个体作为对照组接受了咬肌超声检查。
高达65%的个体显示唾液腺存在解剖变异。临床上标记皮肤的方法显示前点位置经常有误（高达40%的病例），超声证实该点不在肌肉内。在20%的病例中，超声显示进针时需要更长的针头才能进入肌肉。注射后，大多数患者的症状减轻，美容效果和生活质量得到改善。
超声可以成为引导将肉毒杆菌毒素注射到咬肌中的有力工具。它可能有助于实现更个性化的操作、获得更好的美容效果，并有助于避免潜在并发症。
