Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, PO Box 263, FI-00029 HUS, Helsinki, Finland.
J Plast Reconstr Aesthet Surg. 2021 Jul;74(7):1464-1469. doi: 10.1016/j.bjps.2020.12.002. Epub 2020 Dec 5.
To assess botulinum toxin treatment for buccinator muscle synkinesis including: how often the synkinesis was troublesome; who benefitted and how from the treatment; and what were the adverse effects, ideal dosage, and injection site.
Facial palsy (FP) patients and patients with hemifacial spasms who were attending for multiple site botulinum-toxin treatment for facial sequelae were assessed for buccinator synkinesis. The study group comprises those experiencing buccinator synkinesis with associated bothering symptoms who were willing to try injection also to the buccinator muscle.
During 9/2017-12/2019, 126 different patients with facial sequelae were treated with multiple-site botulin-toxin injections by the author. Of them, 83 (66%) received injection also for buccinator synkinesis and 66/82 (80%) wanted to continue with the buccinator injections. The most remarkable results were seen with FP patients biting the mucus membrane of their cheek: usually the biting ceased totally. Patients with powerful hemifacial cheek spasms also experienced cessation of the spasms, contrasting any previous treatments. Adverse effects were mostly mild: slight weakness of the corner of the mouth or additional leakage of saliva or liquids. Only a few patients experienced more pronounced adverse effects. The most posterior contracting part of the buccinator muscle proved to be the best site for the injection.
Buccinator synkinesis was very common and its treatment gave many patients additional relief from facial sequelae symptoms. Professionals treating patients with synkinesis and hemifacial spasms should add well-tolerated buccinator injections to their repertoire of injection sites.
评估肉毒毒素治疗颊肌协同运动，包括：协同运动的困扰频率；治疗的受益人群和获益方式；以及不良反应、理想剂量和注射部位。
面瘫（FP）患者和半面痉挛患者，因面部后遗症正在接受多处肉毒毒素治疗，评估颊肌协同运动。研究组包括有颊肌协同运动且相关症状困扰的患者，他们愿意尝试向颊肌注射肉毒毒素。
在 2017 年 9 月至 2019 年 12 月期间，作者对 126 名不同的面部后遗症患者进行了多处肉毒毒素注射治疗。其中 83 名（66%）患者因颊肌协同运动接受了注射治疗，其中 66/82 名（80%）患者希望继续接受颊肌注射治疗。FP 患者咬颊黏膜的协同运动最为显著：通常完全停止。强有力的半面脸颊痉挛患者也经历了痉挛的停止，与以往任何治疗方法形成对比。不良反应多为轻度：口角轻微无力或额外流涎或液体。只有少数患者出现更明显的不良反应。颊肌最后收缩的部分被证明是注射的最佳部位。
颊肌协同运动非常常见，其治疗为许多患者提供了额外的面部后遗症症状缓解。治疗协同运动和半面痉挛的专业人员应将耐受性良好的颊肌注射纳入其注射部位选择。
