Czumbel László Márk, Farkasdi Sándor, Gede Noémi, Mikó Alexandra, Csupor Dezső, Lukács Anita, Gaál Valéria, Kiss Szabolcs, Hegyi Péter, Varga Gábor
Department of Oral Biology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary.
Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
Front Surg. 2021 Aug 6;8:681028. doi: 10.3389/fsurg.2021.681028. eCollection 2021.
The lips and the mouth play an indispensable role in vocalization, mastication and face aesthetics. Various noxious factors may alter and destruct the original structure, and appearance of the lips and the anatomical area surrounding the mouth. The application of hyaluronic acid (HA) may serve as a safe method for lip regeneration. Although a number of studies exist for HA effectiveness and safety, its beneficial effect is not well-established. The present meta-analysis and systematic review was performed to investigate the effectiveness of HA on lip augmentation. We also investigated the types and nature of adverse effects (AEs) of HA application. We reported our meta-analysis in accordance with the PRISMA Statement. PROSPERO protocol registration: CRD42018102899. We performed the systematic literature search in CENTRAL, Embase, and MEDLINE. Randomized controlled trials, cohort studies, case series and case reports were included. The untransformed proportion (random-effects, DerSimonian-Laird method) of responder rate to HA injection was calculated. For treatment related AEs descriptive statistics were used. The systematic literature search yielded 32 eligible records for descriptive statistics and 10 records for quantitative synthesis. The results indicated that the overall estimate of responders (percentage of subjects with increased lip fullness by one point or higher) was 91% (ES = 0.91, 95% CI:0.85-0.96) 2 months after injection. The rate of responders was 74% (ES = 0.74, 95% CI:0.66-0.82) and 46% (ES = 0.46, 95% CI:0.28-0.65) after 6 and 12 months, respectively. We included 1,496 participants for estimating the event rates of AEs. The most frequent treatment-related AEs were tenderness (88.8%), injection site swelling (74.3%) and bruising (39.5%). Rare AEs included foreign body granulomas (0.6%), herpes labialis (0.6%) and angioedema (0.3%). Our meta-analysis revealed that lip augmentation with injectable HA is an efficient method for increasing lip fullness for at least up to 6 months after augmentation. Moreover, we found that most AEs of HA treatment were mild or moderate, but a small number of serious adverse effects were also found. In conclusion, further well-designed RCTs are still needed to make the presently available evidence stronger.
嘴唇和口腔在发声、咀嚼及面部美学方面发挥着不可或缺的作用。各种有害因素可能改变并破坏嘴唇及口腔周围解剖区域的原始结构和外观。透明质酸（HA）的应用可作为一种安全的唇部再生方法。尽管有许多关于HA有效性和安全性的研究，但其有益效果尚未得到充分证实。本荟萃分析和系统评价旨在研究HA用于丰唇的有效性。我们还调查了HA应用的不良反应（AE）的类型和性质。我们按照PRISMA声明报告了我们的荟萃分析。PROSPERO方案注册号：CRD42018102899。我们在CENTRAL、Embase和MEDLINE中进行了系统的文献检索。纳入了随机对照试验、队列研究、病例系列和病例报告。计算了HA注射反应率的未转换比例（随机效应，DerSimonian-Laird方法）。对于与治疗相关的AE，使用描述性统计。系统文献检索产生了32条符合描述性统计的合格记录和10条用于定量综合的记录。结果表明，注射后2个月，反应者的总体估计值（唇部丰满度增加1分或更高的受试者百分比）为91%（效应量=0.91，95%置信区间：0.85 - 0.96）。6个月和12个月后的反应率分别为74%（效应量=0.74，95%置信区间：0.66 - 0.82）和46%（效应量=0.46，95%置信区间：0.28 - 0.65）。我们纳入了1496名参与者来估计AE的发生率。最常见的与治疗相关的AE是压痛（88.8%）、注射部位肿胀（74.3%）和瘀斑（39.5%）。罕见的AE包括异物肉芽肿（0.6%）、唇疱疹（0.6%）和血管性水肿（0.3%）。我们的荟萃分析表明，注射HA丰唇是一种在丰唇后至少6个月内增加唇部丰满度的有效方法。此外，我们发现HA治疗的大多数AE为轻度或中度，但也发现了少数严重不良反应。总之，仍需要进一步设计良好的随机对照试验来加强目前可用的证据。
