Moore A P, Wood G D
Walton Centre for Neurology and Neurosurgery NHS Trust, Liverpool.
Br Dent J. 1997;183(11-12):415-7. doi: 10.1038/sj.bdj.4809523.
This paper describes a new technique for prophylactic treatment of recurrent mandibular dislocation using injection of botulinum toxin A (BtA) into the lateral pterygoid muscles. BtA temporarily weakens muscles by blocking acetylcholine release, and thus operates through a principle different from established treatments such as joint sclerosant therapy, eminectomy or Dautry's procedure. The patient suffered recurrent mandibular dislocations caused by tardive dystonia. We injected 75 mu BtA percutaneously into each lateral pterygoid muscle under electromyographic guidance. No further dislocations occurred over the subsequent 10 months, and follow-up continues. There were no immediate or delayed side effects. More experience is required before this becomes an established treatment. BtA is usually given in outpatients, and is less invasive or destructive than previous options. It may not be suitable if dislocation is due to lax ligaments or weak muscles. Operators must be aware that other BtA preparations require a different dose.
本文介绍了一种通过向翼外肌注射A型肉毒杆菌毒素（BtA）来预防性治疗复发性下颌关节脱位的新技术。BtA通过阻断乙酰胆碱释放来暂时使肌肉松弛，因此其作用原理与诸如关节硬化剂治疗、髁突切除术或道特里手术等现有治疗方法不同。该患者因迟发性肌张力障碍导致复发性下颌关节脱位。我们在肌电图引导下经皮向每侧翼外肌注射75微克BtA。在随后的10个月内未再发生脱位，随访仍在继续。未出现即刻或延迟的副作用。在该方法成为一种既定治疗方法之前，还需要更多经验。BtA通常在门诊给药，与之前的治疗方法相比，侵入性更小或破坏性更小。如果脱位是由于韧带松弛或肌肉无力，则可能不适用。操作人员必须意识到，其他BtA制剂需要不同的剂量。
