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[颊肌:肉毒杆菌毒素注射治疗面瘫后遗症的新靶点]

[Buccinator muscle: A new target for botulinum toxin injections in the treatment of facial paralysis sequelae].

作者信息

Lacroix G, Duquennoy-Martinot V, Guerreschi P

机构信息

Service de chirurgie plastique, CHU de Lille, hôpital Salengro, 59037 Lille cedex, France.

出版信息

Ann Chir Plast Esthet. 2022 Jun;67(3):125-132. doi: 10.1016/j.anplas.2022.04.001. Epub 2022 May 31.

Abstract

AIM OF THE STUDY

Facial paralysis can cause aesthetic and functional sequelae such as spasms and synkinesis. Botulinum toxin injection is one of the key treatments for these sequelae. Its use is widely reported in the literature for many muscles of the face but little for the buccinator muscle. However, its hyperactivity can be disabling, generating chewing and smile disorders in particular. The aim of this prospective study is to report the effects of botulinum toxin using a questionnaire specifically for the buccinator muscle.

PATIENTS AND METHODS

The study was conducted on 13 patients. The facial paralysis was of various origins. The questionnaire consisted of 10 questions each assessing a facial mimic involving the buccinator muscle. The rating scale ranged from -10 (major deterioration) to 10 (major improvement) for each question. The evaluation was done at 1 and 4 months after the injection. We found an improvement for all the mimics and gestures evaluated (0 to 7.38 at 1 month and 0.15 to 6.62 at 4 months). This improvement was greater at 1 month than at 4 months. Few side effects were reported.

CONCLUSION

Botulinum toxin injections are an effective, safe therapeutic solution for the treatment of the facial paralysis sequelae of the buccinator muscle through a new specific questionnaire. Subsequently, it would be interesting to carry out an evaluation on a larger population and to compare it with other recognized scores in facial paralysis.

摘要

研究目的

面瘫可导致诸如痉挛和联带运动等美学和功能后遗症。肉毒杆菌毒素注射是治疗这些后遗症的关键方法之一。文献中广泛报道了其在面部许多肌肉中的应用,但在颊肌方面的报道较少。然而,颊肌功能亢进可能会使人丧失能力,尤其会导致咀嚼和微笑障碍。这项前瞻性研究的目的是通过一份专门针对颊肌的问卷来报告肉毒杆菌毒素的效果。

患者与方法

该研究对13名患者进行。面瘫病因各异。问卷由10个问题组成,每个问题评估一个涉及颊肌的面部表情。每个问题的评分范围从-10(严重恶化)到10(显著改善)。评估在注射后1个月和4个月进行。我们发现所有评估的表情和动作均有改善(1个月时为0至7.38,4个月时为0.15至6.62)。1个月时的改善比4个月时更大。报告的副作用很少。

结论

通过一种新的特定问卷,肉毒杆菌毒素注射是治疗颊肌面瘫后遗症的一种有效、安全的治疗方法。随后,对更大规模人群进行评估并与面瘫的其他公认评分进行比较将是很有意义的。

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