Diracoglu Demirhan, Sahbaz Tugba, Alptekin Kerem, Dogan Nalan
Department of Physical Medicine and Rehabilitation, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
Turk J Phys Med Rehabil. 2021 Sep 1;67(3):351-356. doi: 10.5606/tftrd.2021.6288. eCollection 2021 Sep.
This study aims to explore effects of ultrasound-assisted injection of the botulinum neurotoxin-A (BoNT-A) on muscle thickness (MT) in patients with masseter hypertrophy.
Between December 2018 and December 2019, a total of 20 patients (3 males, 17 females; mean age: 28±6.9 years; range, 18 to 42 years) with bruxism who underwent BoNT-A injections were reviewed retrospectively. The patients were treated using individualized injection dosages and sites. Assessment methods included length between the tragus and the angle of the mouth, maximal bite force, and MT of the masseter muscle. Follow-up data were collected from the hospital electronic database.
There were 26 masseter muscles with masseter hypertrophy in 20 patients. There was a significant difference in ultrasonographic measurements of the relaxed and contracted masseter muscles between the baseline and two weeks, one month and three months after the treatment (p<0.05). In the ultrasonographic measurement of the relaxed masseter muscle, post-treatment third month values significantly differed from the second week values. The differences in the measurement of the line between the tragus and the angle of the mouth between the baseline and two weeks, one month and three months after the treatment were statistically significant (p<0.05). In the maximal bite force measurements, no significant difference was observed between the baseline and post-intervention measurements (p>0.05).
The MT decreases after a single dose of BoNT-A injection in patients with masseter muscle hypertrophy and ultrasonography is a convenient imaging modality for BoNT-A injection to the masseter.
本研究旨在探讨超声辅助注射A型肉毒杆菌毒素（BoNT-A）对咬肌肥大患者肌肉厚度（MT）的影响。
回顾性分析2018年12月至2019年12月期间接受BoNT-A注射的20例磨牙症患者（3例男性，17例女性；平均年龄：28±6.9岁；范围18至42岁）。患者采用个体化注射剂量和部位进行治疗。评估方法包括耳屏与口角之间的长度、最大咬合力以及咬肌的MT。随访数据从医院电子数据库收集。
20例患者中有26块咬肌存在咬肌肥大。治疗前基线与治疗后两周、1个月和3个月时，放松和收缩状态下咬肌的超声测量值存在显著差异（p<0.05）。在放松状态下咬肌的超声测量中，治疗后第3个月的值与第2周的值有显著差异。治疗前基线与治疗后两周、1个月和3个月时，耳屏与口角之间连线的测量差异具有统计学意义（p<0.05）。在最大咬合力测量中，基线与干预后测量值之间未观察到显著差异（p>0.05）。
咬肌肥大患者单次注射BoNT-A后MT降低，超声检查是向咬肌注射BoNT-A的一种便捷成像方式。
