Bikhazi N B, Maas C S
Department of Otolaryngology/Head and Neck Surgery, University of California, San Francisco 94143, USA.
Otolaryngol Head Neck Surg. 1997 Oct;117(4):303-7. doi: 10.1016/S0194-5998(97)70117-7.
A number of surgical procedures exist to improve facial symmetry for patients with facial paralysis. Whereas static symmetry is often improved, dynamic asymmetry frequently persists because of the imbalance of complex coordinated movements of facial expression. The paralyzed face is often distorted by the excessive pull of the normal contralateral face during emotional expression. This study reports an expanded clinical indication for botulinum toxin in patients with unilateral facial paralysis. Ten patients with facial paralysis and markedly asymmetric smiles were treated with botulinum toxin A injections into the contralateral zygomaticus major, levators labii superioris and angulii oris, or risorius muscles. Eight of the 10 patients noted improvement in the symmetry of their smiles and underwent repeat injections. The onset and duration of effect averaged 5.9 days and 3 months, respectively. Botulinum toxin therapy provides a safe and efficacious modality for refining the appearance of the paralyzed face during mimetic activity.
目前有多种外科手术可用于改善面瘫患者的面部对称性。虽然静态对称性通常能够得到改善，但由于面部表情复杂协调运动的失衡，动态不对称情况仍经常存在。在情感表达时，瘫痪侧的面部常因健侧面部的过度牵拉而变形。本研究报告了肉毒杆菌毒素在单侧面瘫患者中的一项扩展临床应用指征。对10例面瘫且笑容明显不对称的患者，在其对侧的颧大肌、上唇提肌、口轮匝肌或笑肌注射A型肉毒杆菌毒素。10例患者中有8例注意到笑容对称性有所改善，并接受了重复注射。效果的起效时间和持续时间平均分别为5.9天和3个月。肉毒杆菌毒素疗法为改善面瘫患者在模仿活动时的面部外观提供了一种安全有效的方式。
