Kim Sang-Yun, Kim Young-Kyun, Yun Pil-Young, Bae Ji-Hyun
1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, South Korea.
2Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
Maxillofac Plast Reconstr Surg. 2018 Aug 6;40(1):21. doi: 10.1186/s40902-018-0159-z. eCollection 2018 Dec.
The purpose of this study was to evaluate the clinical outcomes of treatment of non-odontogenic atypical orofacial pain using botulinum toxin-A.
This study involved seven patients (seven females, mean age 65.1 years) who had non-odontogenic orofacial pain (neuropathic pain and atypical orofacial pain) and visited the Seoul National University Bundang Hospital between 2015 and 2017. All medication therapies were preceded by botulinum toxin-A injections, followed by injections in the insignificant effects of medication therapies. Five of the seven patients received intraoral injections in the gingival vestibule or mucosa, while the remaining two received extraoral injections in the masseter and temporal muscle areas.
In five of the seven patients, pain after botulinum toxin-A injection was significantly reduced. Most of the patients who underwent surgery for dental implantation or facial nerve reconstruction recovered after injections. However, the pain did not disappear in two patients who reported experiencing persistent pain without any cause.
The use of botulinum toxin-A for the treatment of non-odontogenic neuropathic orofacial pain is clinically useful. It is more effective to administer botulinum toxin-A in combination with other medications and physical therapy to improve pain.
本研究的目的是评估使用A型肉毒杆菌毒素治疗非牙源性非典型性口面部疼痛的临床疗效。
本研究纳入了7例患者(均为女性,平均年龄65.1岁),这些患者患有非牙源性口面部疼痛(神经性疼痛和非典型性口面部疼痛),并于2015年至2017年期间就诊于首尔国立大学盆唐医院。所有药物治疗均在A型肉毒杆菌毒素注射之后进行,若药物治疗效果不佳则再次进行注射。7例患者中有5例接受了牙龈前庭或黏膜的口内注射,其余2例接受了咬肌和颞肌区域的口外注射。
7例患者中有5例在注射A型肉毒杆菌毒素后疼痛明显减轻。大多数接受牙种植手术或面神经重建手术的患者在注射后恢复。然而,有2例患者报告无缘无故持续疼痛,疼痛并未消失。
使用A型肉毒杆菌毒素治疗非牙源性神经性口面部疼痛在临床上是有用的。将A型肉毒杆菌毒素与其他药物及物理治疗联合使用以改善疼痛更有效。