D'Andrea Franco Patriani, Alessi Cristina, Cárcano Cristiane, Tanaka Vanessa, Alvares Bruno, Brito Davi, Guerra Isabela Alves, Gama Ricardo, Riberto Marcelo
Department of Dermatology, Hospital de Amor, Barretos, Brazil.
Department of head and Neck Surgery, Hospital de Amor, Barretos, Brazil.
Aesthetic Plast Surg. 2024 Dec 12. doi: 10.1007/s00266-024-04589-8.
Neoplasms in the head and neck often lead to peripheral facial paralysis (PFP), impacting facial expression and causing psychological distress. Standard treatments involve physiotherapy, but botulinum toxin type A (BTA) and hyaluronic acid (HA) injections have shown promise in promoting facial symmetry.
To assess the effectiveness of combined BTA and HA intervention in PFP patients, comparing it to conventional treatment (physiotherapy).
A single-blind, randomized clinical trial at Hospital de Amor de Barretos included 18 patients, with the control group receiving standard therapy and the combined therapy (CT) group receiving BTA and HA. Evaluations utilized the Sunnybrook facial grading scale (SFGS) and Psychosocial Facial Asymmetry Scale (EPAF) questionnaires, along with photographic analysis.
CT significantly improved facial symmetry and psychosocial aspects compared to the control group. The SFGS scores increased by 27 points in CT versus 3 points in the control group, while EPAF scores decreased by 16 points in CT and increased by 1 point in the control group. Photographic analysis showed improved dynamic smiles in CT patients. Functional gains were more evident at 30 days, with continued improvement over four months. Psychosocial scores increased throughout the study. Only two CT patients reported transient issues with drinking and chewing.
The study suggests the positive impact of combined therapy on psychosocial and functional aspects, emphasizing the need for further robust research to determine its therapeutic potential.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
头颈部肿瘤常导致周围性面瘫（PFP），影响面部表情并造成心理困扰。标准治疗方法包括物理治疗，但A型肉毒毒素（BTA）和透明质酸（HA）注射在促进面部对称方面显示出前景。
评估BTA和HA联合干预对PFP患者的有效性，并与传统治疗（物理治疗）进行比较。
在巴雷托斯爱之医院进行的一项单盲随机临床试验纳入了18名患者，对照组接受标准治疗，联合治疗（CT）组接受BTA和HA治疗。评估采用了桑尼布鲁克面部分级量表（SFGS）和心理社会面部不对称量表（EPAF）问卷，以及照片分析。
与对照组相比，CT组在面部对称性和心理社会方面有显著改善。CT组的SFGS评分增加了27分，而对照组增加了3分；CT组的EPAF评分降低了16分，而对照组增加了1分。照片分析显示CT组患者的动态笑容有所改善。功能改善在30天时更为明显，并在四个月内持续改善。心理社会评分在整个研究过程中都有所提高。只有两名CT组患者报告了饮水和咀嚼方面的短暂问题。
该研究表明联合治疗对心理社会和功能方面有积极影响，强调需要进一步进行有力研究以确定其治疗潜力。
证据水平II：本杂志要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
