Päijät-Häme Joint Authority for Health and Wellbeing, Päijät- Häme Central Hospital, Keskussairaalankatu 7, Lahti.
Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, Finland. Topeliuksenkätu 35, 00029 HUS, Finland.
J Craniofac Surg. 2022 Jun 1;33(4):1159-1161. doi: 10.1097/SCS.0000000000008331. Epub 2021 Nov 5.
The aim of this study was to analyze the clinical outcome of the use of botulinum toxin type A (BTX) intramuscular injections to the head and neck, particularly the masticatory muscles of patients with temporomandibular disorder (TMD).
The medical records of all patients who had received intramuscular BTX injections between 2005 and 2018 at Päijät- Häme Central Hospital, Lahti, Finland were analyzed retrospectively. Gender, age, previous medical history, number of injections, injection areas, and therapeutic results were collected and analyzed. The outcome was divided into three categories based on the patients' subjective reports: not beneficial, beneficial, and highly beneficial.
A total of 68 patients had received intramuscular BTX injections in our unit for TMD symptoms. Clinical effectiveness could be analyzed from 63 patients. Overall, 87% of them reported fävorable outcomes. 8 (13%) reported BTX injections as not beneficial, 15 (24%) as beneficial, and 40 patients (63%) as highly beneficial.Most patients had already received conventional treatment with an occlusal splint (93%) combined with pain medication (60%) in the primary care units before they were referred to our hospital.There were 59 (83%) female patients, and they responded better to BTX therapy than the male patients: 91% versus 57% (P value = 0.04). Average age at the first BTX injection visit was 44.6 years (range 17.8-77.2). Most commonly (65%), BTX was divided bilaterally to the masseter and temporalis muscles.
BTX injections had good therapeutic outcomes for our TMD patients. However, most patients require multiple injection visits.
本研究旨在分析肉毒毒素 A（BTX）肌内注射治疗颞下颌关节紊乱病（TMD）患者头颈部，特别是咀嚼肌的临床效果。
回顾性分析了 2005 年至 2018 年期间在芬兰拉赫蒂的 Päijät-Häme 中央医院接受肌内 BTX 注射的所有患者的病历。收集并分析了性别、年龄、既往病史、注射次数、注射部位和治疗效果。根据患者的主观报告，将结果分为三类：无益处、有益和非常有益。
共有 68 例 TMD 患者在我院接受肌内 BTX 注射，其中 63 例可进行临床疗效分析。总体而言，87%的患者报告治疗效果良好。8 例（13%）患者认为 BTX 注射无益处，15 例（24%）患者认为有益，40 例（63%）患者认为非常有益。大多数患者在转诊到我院之前已经在初级保健单位接受了常规治疗，包括咬合夹板（93%）和疼痛药物治疗（60%）。患者中女性 59 例（83%），对 BTX 治疗的反应优于男性：91%比 57%（P 值=0.04）。首次 BTX 注射就诊时的平均年龄为 44.6 岁（17.8-77.2 岁）。最常见的是（65%），BTX 双侧注射到咬肌和颞肌。
BTX 注射对我们的 TMD 患者有良好的治疗效果。然而，大多数患者需要多次注射治疗。
