Blitzer A, Brin M F, Keen M S, Aviv J E
Department of Otolaryngology, Columbia-Presbyterian Medical Center, New York, NY.
Arch Otolaryngol Head Neck Surg. 1993 Sep;119(9):1018-22. doi: 10.1001/archotol.1993.01880210108015.
To determine the effectiveness of botulinum toxin injections for the management of hyperfunctional facial lines in patients with dystonia.
Twenty-six patients were included in the study: 24 patients had dystonic movement of the face as either a primary or secondary component, and two patients were treated for purely hyperfunctional lines. Botulinum toxin type A was injected via a monopolar hollow-bore Teflon-coated electromyography needle into the facial muscles associated with the hyperfunctional lines. Doses were divided into 1.25- to 10-U aliquots. Qualitative assessments by the patient and physician were made before injection and 2 to 3 weeks after injection.
Twenty-six patients (two male and 24 female) with hyperfunctional lines were included. The ages were from 32 to 84 years with an average age of 59 years. Twenty had dystonia, four had hemifacial spasm, and two had pure hyperfunction without neuromuscular disease.
All of the patients had an effect of toxin within the first 24 to 72 hours. All of the patients experienced benefit from the toxin injections with partial or total resolution of painful contractions or unsightly hyperfunctional lines and spasms. The effects of the injection lasted 3 to 6 months. No systemic side effects were noted. Adverse effects included mild, temporary eyelid or lip weakness.
Based on this initial pilot study, botulinum toxin may be an important new option for the treatment of patients with hyperfunctional facial lines.
确定肉毒杆菌毒素注射治疗肌张力障碍患者面部功能亢进性皱纹的有效性。
26例患者纳入本研究：24例患者面部有肌张力障碍性运动，为主要或次要表现，2例患者仅接受功能性亢进性皱纹治疗。A型肉毒杆菌毒素通过单极空心聚四氟乙烯涂层肌电图针注射到与功能性亢进性皱纹相关的面部肌肉中。剂量分为1.25至10单位的等分剂量。患者和医生在注射前及注射后2至3周进行定性评估。
纳入26例有功能性亢进性皱纹的患者（2例男性和24例女性）。年龄32至84岁，平均年龄59岁。20例有肌张力障碍，4例有半面痉挛，2例有单纯功能亢进，无神经肌肉疾病。
所有患者在最初24至72小时内均出现毒素作用。所有患者均从毒素注射中获益，疼痛性收缩或难看的功能性亢进性皱纹及痉挛部分或完全缓解。注射效果持续3至6个月。未观察到全身副作用。不良反应包括轻度、暂时性眼睑或唇部无力。
基于这项初步的试点研究，肉毒杆菌毒素可能是治疗面部功能亢进性皱纹患者的一个重要新选择。
