Choe Won Joo, Kim Jin
a Department of Anaesthesiology and Pain Medicine , Inje University College of Medicine, Ilsan Paik Hospital , Gyeonggi-do , Korea ;
b Department of Otorhinolaryngology , Inje University College of Medicine, Ilsan Paik Hospital , Gyeonggi-do , Korea.
Acta Otolaryngol. 2016 Sep;136(9):952-5. doi: 10.3109/00016489.2016.1165864. Epub 2016 Apr 12.
Wider-area botulinum toxin (BT) injection with the dosage depending on specific pathology is a promising approach for the treatment of hemifacial spasm (HFS), resulting in effective and long-lasting control of HFS with fewer side-effects.
The aim of this study was to develop a BT injection strategy that minimizes complications by considering the causes, duration, and electrophysiologic features of the disease, as well as the patient's age.
From July 2011 to July 2015, 26 patients were included in the strategy. The mean age was 61.8 ± 14.6. In the case of essential HFS, 2 units/injection site was the standard dosage. If a patient was aged over 60 and had a reduced electromyogram (EMG) amplitude, the dosage was reduced by 0.5 units/site. In the case of post-paralytic and tumor-induced HFS, 1.5 units/site was the standard dosage. All cases were managed by alternating injections of Botox and Dysport with no physical therapy.
Most HFS patients treated with the injection strategy had complete remission of HFS within 1 week. The average number of BT injection sites was 22.6 ± 6.7. The mean total BT dosage on the affected side was 28.6 ± 4.9 units. The mean duration of BT efficacy was 28.6 ± 7.7 weeks.
根据具体病情调整剂量进行大面积肉毒杆菌毒素（BT）注射是治疗面肌痉挛（HFS）的一种有前景的方法，可有效且持久地控制HFS，副作用较少。
本研究旨在制定一种BT注射策略，通过考虑疾病的病因、病程、电生理特征以及患者年龄，将并发症降至最低。
2011年7月至2015年7月，26例患者纳入该策略。平均年龄为61.8±14.6岁。对于原发性HFS，标准剂量为每注射部位2单位。如果患者年龄超过60岁且肌电图（EMG）振幅降低，则每部位剂量减少0.5单位。对于麻痹后和肿瘤诱发的HFS，标准剂量为每部位1.5单位。所有病例均采用交替注射保妥适和得宝松治疗，无需物理治疗。
大多数采用该注射策略治疗的HFS患者在1周内HFS完全缓解。BT注射部位的平均数量为22.6±6.7个。患侧BT总剂量平均为28.6±4.9单位。BT疗效的平均持续时间为28.6±7.7周。
