• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.121-129
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• 2005

In this experiment, eleven volunteers were followed up for 15 months after the injection of botulinum toxin type A on right and left masseter muscles. The measurement of masseter muscle atrophy for each volunteer was performed by CT(computed tomography) three times: before the injection, three and fifteen months after the injection. The thickness and area of muscle were measured in three positions which are 10 (position 1), 20 (position 2), and 40 mm (position 3) above the inferior border of mandible(the injection site was nearest the position 1). The thickness of masster muscle was decreased in all three positions three months after the injection, but no significant change was observed fifteen months after the injection. On the other hand, the area of masster muscle was decreased in all three positions three months after the injection. Furthermore, the area was decreased significantly in positions 1 and 2, but not in position 3 fifteen months after the injection. As a result, toxin is still in effect even fifteen months after the injection. Finally, the present study shows that the measurement of muscle area provides more precise informations than that of muscle thickness does.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.247-251
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• 2011

Botulinum toxin type A (BoNT-A) is used for treating bilateral masseter hypertrophy since 1994. Recently there have been more clinical studies in this area, with some authors reporting that BoNT-A can reduce the size of the masseter muscle, as documented by photography, ultrasonography, computed tomography, and 3D(three dimensional) laser scan. However, earlier studies were only for bilateral masseter hypertrophy cases, not for unilateral masseter hypertrophy cases. The aim of this study was to use 3D laser scanning to evaluate changes in the external facial contour induced by unilateral BoNT-A injection. BoNT-A was injected into hypertrophic masseter muscle unilaterally in 10 patients with asymmetric masseter hypertrophy. The clinical effects of unilaterally injected BoNT-A were evaluated before the injection and 4, 8, and 12weeks after the injection using 3D laser scan. And the mean values of both sides (injection and non-injection sides) were compared with. At injection side, mean values of the volume and the bulkiest height at each time point diminished significantly between pre-injection and 4, 8, and 12weeks post-injection. At non-injection side, in contrast, mean values of the volume and the bulkiest height diminished also but less than that of injected side, and there was no statistical significance. In this limited study, we concluded that the unilaterally BoNT-A injection side showed greater mean values of the reduction of muscle volume than non-injection side at 4, 8, and 12 weeks after the injection.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.2
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• pp.61-72
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• 2021

A beautiful smile is made when it is symmetrical and gums are displayed less than 2 - 3 mm. Excessive gingival display also known as "gummy smile" is often recognized to be unaesthetic. Causes of gummy smile can be caused by delayed eruption, vertical maxillary excess, hypermobile upper lip, or a short upper lip. Meanwhile botulinum toxin which is an exotoxin produced from Clostridium botulinum, works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles. The application site and weakens the muscle tone is drawing attention as a gummy smile treatment caused by hypermobile upper lip. There have been many studies about the method of injecting botulinum toxin into muscles around the lips, but there is still no standardized research method and treatment method, so there is controversy over the therapeutic effect. The aim of this study is to review the previous studies about the predictors of indication and effects of gummy smile treatment using botulinum toxin injection. Especially we tried to propose a protocol for optimal dose and efficient injection point through the anatomical considerations for gummy smile treatment using botulinum toxin.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.1
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• pp.52-55
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• 2011

Hyperfunction of the upper esophageal sphincter (UES) can cause severe dysphagia. This condition referred as cricopharyngeal dysphagia may occur after head and neck surgery due to altered muscle spasm and stenosis of the pharyngo-esophageal segment. Among various treatment options available, Botulinum toxin A (Botox) injection offers a nonsurgical treatment which is useful especially for debilitated patients, and there has been a recent increase in the clinical use of Botox by otolaryngologists for managing such conditions. A 55-year-old male with base of tongue (BOT) cancer suffered from severe dysphagia after total glossectomy and neck dissection treatment. Videofluoroscopic swallow study (VFSS) and flexible endoscopic evaluation of swallowing (FEES) showed inability to pass food through the UES due to cricopharyngeal spasm. After injection of 10 U of Bot ox into each cricopharyngeus muscles (total 20 U) via EMG-guided percutaneous injection, swallowing function had improved and oral nutrition was possible, with food passing through the UES visualized on VFSS and FEES.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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• pp.35-38
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• 2020

Spasmodic dysphonia is a disease presumed to be a form of focal laryngeal dystonia. The widely used first-line treatment is botulinum toxin injection to the thyroarytenoid muscles. In spite of the effectiveness and safety of this method, it has a temporary effect that lasts only several months, resulting the patients' symptom fluctuating, called 'Botox rollercoaster.' Some surgical techniques had tried, but they had shown several limitations including high rate of recurrence. We tried thyroarytenoid myectomy with selective recurrent laryngeal nerve section in a patient with intractable spasmodic dysphonia. This procedure is an alternative treatment of spasmodic dysphonia to prevent recurrence and improve symptoms. During five years of follow-up, she has shown steady quality voice without any complication. To the best of our knowledgement, this is the longest follow-up case of this operation in South Korea.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.2
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• pp.204-209
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• 1997

In the treatment of spasmodic dysphonia, laryngeal injection of botulinum toxin has been reported to be successful. The treatment of adductor type spasmodic dysphonia with botulinum toxin type A injection using EMG was conducted in 24 patients and it's effect was compared with results from flexible nasopharyngoscopy guided injection(29 patients) and telelaryngoscopy guided injection(31 patients). Sixty two point five percent(62.5%) of patients using EMG and 75.8% of patients using flexible nasopharyngoscope and 90.0% of patients using telelaryngoscope reported that the patient's symptom was improved. The functional status of the patient's disorder was classified into low grades. The mean pre-injection grade for patients using EMG, flexible nasopharyngoscope and telelaryngoscope was 1.7, 1.6 and 2.1 respectively. And it was lowered to 1.0, 0.7 and 1.1 respectively after the injection. Results were similar(p＜0.05). As a self assessment method, patients were asked to rate their voice on a scale of 100. In this study, the mean pre-injection score was 66.3, 44.0 and 40.0 respectively. And it was improved to 74.8, 77.7 and 69.8 respectively after the injection. Among 23 patients who undergone above 3method, 17 patients(73.9%) told that EMG-guided botulinum injection was preferable method in its convenience and effectiveness. In conclusion, EMG guided botulinum toxin injection is an another effective method for the treatment of adductor type spasmodic dysphonia similar to telelaryngoscopy-guided injection and flexible nasopharyngoscopy guided injection.