Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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The significance of split-face studies and electromyography in forehead rejuvenation

  • Bomin Moon (Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Ki Young Park (Gachon University College of Medicine) ;
  • Hye Gwang Mun (Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Yun Sang Kim (Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Yu Jin Kim (Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine)
  • Received : 2023.09.14
  • Accepted : 2023.10.09
  • Published : 2023.10.20
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Abstract

Background: Botulinum toxin is a neurotoxic substance with a wide range of uses, from the treatment of musculoskeletal spasms to anti-aging regimens by improving wrinkles. Split-face studies in which drugs are injected in the right and left sides of the faces have been actively conducted in botulinum toxin studies. In this study, we aimed to investigate the reliability of a split-face study for determining the effectiveness of botulinum toxin based on eyebrow height and movement, and electromyography results. Methods: Thirty-one women aged 35 to 55 years were included in the study. Eyebrow height was measured as the distance from the eyebrows to the upper eyelid margin on the primary gaze, and eyebrow movement was measured as the distance when the forehead was wrinkled for 5 seconds. A noninvasive method was used for electromyography of the frontalis muscles. Results: No statistically significant differences in right and left eyebrow heights and movements, and electromyography findings (p= 0.256, p= 1.000, and p= 0.978, respectively) were found. Pearson correlation analysis showed that electromyography muscle activity is positively associated with eyebrow movement, respectively (p< 0.001). Conclusion: We advocate the reliability of split-face study and the usefulness of electromyography of frontalis muscle in forehead rejuvenation research.

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References

  1. Garritano FG, Quatela VC. Surgical anatomy of the upper face and forehead. Facial Plast Surg 2018;34:109-13.  https://doi.org/10.1055/s-0038-1637727
  2. Costin BR, Plesec TP, Sakolsatayadorn N, Rubinstein TJ, McBride JM, Perry JD. Anatomy and histology of the frontalis muscle. Ophthalmic Plast Reconstr Surg 2015;31:66-72.  https://doi.org/10.1097/IOP.0000000000000244
  3. Wieder JM, Moy RL. Understanding botulinum toxin: surgical anatomy of the frown, forehead, and periocular region. Dermatol Surg 1998;24:1172-4.  https://doi.org/10.1111/j.1524-4725.1998.tb04093.x
  4. Cotofana S, Mian A, Sykes JM, Redka-Swoboda W, Ladinger A, Pavicic T, et al. An update on the anatomy of the forehead compartments. Plast Reconstr Surg 2017;139:864e-872e.  https://doi.org/10.1097/PRS.0000000000003174
  5. Langsdon P, Petersen D. Management of the aging forehead and brow. Facial Plast Surg 2014;30:422-30.  https://doi.org/10.1055/s-0034-1383555
  6. Arnaoutakis D, Bassichis B. Surgical and nonsurgical techniques in forehead rejuvenation. Facial Plast Surg 2018;34:466-73.  https://doi.org/10.1055/s-0038-1669990
  7. Park MY, Ahn KY. Scientific review of the aesthetic uses of botulinum toxin type A. Arch Craniofac Surg 2021;22:1-10.  https://doi.org/10.7181/acfs.2021.00003
  8. Peng Chen Z, Morris JG Jr, Rodriguez RL, Wagle Shukla A, Tapia-Nunez J, Okun MS. Emerging opportunities for serotypes of botulinum neurotoxins. Toxins (Basel) 2012;4:1196-222.  https://doi.org/10.3390/toxins4111196
  9. Prager W, Wissmuller E, Kollhorst B, Williams S, Zschocke I. Comparison of two botulinum toxin type A preparations for treating crow's feet: a split-face, double-blind, proof-of-concept study. Dermatol Surg 2010;36 Suppl 4:2155-60.  https://doi.org/10.1111/j.1524-4725.2010.01798.x
  10. Karsai S, Adrian R, Hammes S, Thimm J, Raulin C. A randomized double-blind study of the effect of botox and dysport/reloxin on forehead wrinkles and electromyographic activity. Arch Dermatol 2007;143:1447-62.  https://doi.org/10.1001/archderm.143.11.1447-b
  11. Spiegel LL, Ostrem JL, Bledsoe IO. FDA approvals and consensus guidelines for botulinum toxins in the treatment of dystonia. Toxins (Basel) 2020;12:332. 
  12. Cocco A, Albanese A. Recent developments in clinical trials of botulinum neurotoxins. Toxicon 2018;147:77-83.  https://doi.org/10.1016/j.toxicon.2017.08.014
  13. Shome D, Kapoor R, Khare S. Two different types of botulinum toxins: is there a difference in efficacy and longevity? J Cosmet Dermatol 2019;18:1635-41.  https://doi.org/10.1111/jocd.12949
  14. Choi JW, Youn CS, An HT, Yoo JY, Na JI, Park KC, et al. Combined use of botulinum toxin type A and B for forehead rhytides: a randomized, double-blind, split-face study. J Dermatolog Treat 2013;24:126-32.  https://doi.org/10.3109/09546634.2011.595772
  15. Yaraskavitch M, Leonard T, Herzog W. Botox produces functional weakness in non-injected muscles adjacent to the target muscle. J Biomech 2008;41:897-902.  https://doi.org/10.1016/j.jbiomech.2007.11.016
  16. Shaari CM, George E, Wu BL, Biller HF, Sanders I. Quantifying the spread of botulinum toxin through muscle fascia. Laryngoscope 1991;101:960-4.  https://doi.org/10.1288/00005537-199109000-00006
  17. Ramirez-Castaneda J, Jankovic J, Comella C, Dashtipour K, Fernandez HH, Mari Z. Diffusion, spread, and migration of botulinum toxin. Mov Disord 2013;28:1775-83.  https://doi.org/10.1002/mds.25582
  18. Punga AR, Eriksson A, Alimohammadi M. Regional diffusion of botulinum toxin in facial muscles: a randomised double-blind study and a consideration for clinical studies with split-face design. Acta Derm Venereol 2015;95:948-51.  https://doi.org/10.2340/00015555-2093
  19. Girlanda P, Quartarone A, Sinicropi S, Nicolosi C, Messina C. Unilateral injection of botulinum toxin in blepharospasm: single fiber electromyography and blink reflex study. Mov Disord 1996;11:27-31.  https://doi.org/10.1002/mds.870110107
  20. Weise D, Weise CM, Naumann M. Central effects of botulinum neurotoxin: evidence from human studies. Toxins (Basel) 2019;11:21. 
  21. Matak I. Evidence for central antispastic effect of botulinum toxin type A. Br J Pharmacol 2020;177:65-76.  https://doi.org/10.1111/bph.14846
  22. Rantanen V, Ilves M, Vehkaoja A, Kontunen A, Lylykangas J, Makela E, et al. A survey on the feasibility of surface EMG in facial pacing. Annu Int Conf IEEE Eng Med Biol Soc 2016;2016:1688-91. 
  23. De Letter M, Vanhoutte S, Aerts A, Santens P, Vermeersch H, Roche N, et al. Facial nerve regeneration after facial allotransplantation: a longitudinal clinical and electromyographic follow-up of lip movements during speech. J Plast Reconstr Aesthet Surg 2017;70:729-33.  https://doi.org/10.1016/j.bjps.2017.02.025
  24. Lee SY, Kim SH, Hwang JH, Kim KS. Sensory recovery after infraorbital nerve avulsion injury. Arch Craniofac Surg 2020;21:244-8.  https://doi.org/10.7181/acfs.2020.00290
  25. Koo WY, Park SO, Ahn HC, Ryu SR. Facial reanimation using the hypoglossal nerve and ansa cervicalis: a short-term retrospective analysis of surgical outcomes. Arch Craniofac Surg 2021;22:303-9. https://doi.org/10.7181/acfs.2021.00444