• 제목/요약/키워드: Type A botulinum toxin injection

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A형 보튤리늄 톡신의 안면부 미용학적 적용 (Cosmetic Use of Botulinum Toxin Type A in the Face)

  • 강제구
    • 대한후두음성언어의학회지
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    • 제23권2호
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    • pp.111-118
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    • 2012
  • Botulinum toxin is a potent neurotoxin that is produced by the bacterium Clostridium botulinum. The agent causes muscle paralysis by preventing the release of acetylcholine at the neuromuscular junction of striated muscle. Botulinum toxin A (Botox, AllerganInc., Irvine, California) is the most potent of seven distinct toxin subtypes that are produced by the bacterium. The toxin was initially used clinically in the treatment of strabismus caused by hypertonicity of the extraocular muscles and was sub-sequently described in the treatment of multiple disorders of muscular spasticity and dystonia. In treating patients with Botox for blepharospasm, Carruthers and Carruthers [5] noticed an improvement in glabellar rhytids. This ultimately led to the introduction and development of Botox as a mainstay in the treatment of hyperfunctional facial lines in the upper face. Since its approval by the U.S. Food and Drug Administration for the treatment of facial rhytids (2002), botulinum toxin A has expanded into wide-spread clinical use. Forehead, glabellar, and periocular rhytids are the most frequently treated facial regions. Indications for alternative uses for Botox in facial plastic and reconstructive surgery are expanding. These include a variety of well-established procedures that use Botox as an adjunctive agent to enhance results. In addition, Botox injection is finding increased usefulness as an independent modality for facial rejuvenation and rehabilitation. The agent is used beyond its role in facial rhytids as an effective agent in the management of dynamic disorders of the face and neck. Botox injection allows the physician to precisely manipulate the balance between complex and conflicting muscular interactions, thus resetting their equilibrium state and exerting a clinical effect. This article will address some of the new and unique indications on Botox injection in the face (the lower face and neck, combination with fillers). Important points in terms of its clinical relevance will be stressed, such as an understanding of functional facial anatomy, the importance of precise injections, and correct dosing all are critical to obtaining natural outcomes.

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Effects of a botulinum toxin type A injection on the masseter muscle: An animal model study

  • Park, Si-Yeok;Park, Young-Wook;Ji, Young-Jun;Park, Sung-Wook;Kim, Seong-Gon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제37권
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    • pp.10.1-10.5
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    • 2015
  • Background: The aim of this study was to investigate the effect of a botulinum toxin type A (BTX-A) injection in the masseter muscle using electromyography (EMG) in an animal model. Methods: Ten male adult (>3 months of age) New Zealand white rabbits were used. Muscle activity was continuously recorded from 8 hours before to 8 hours after BTX-A injection. The rabbits received unilateral BTX-A injections of either 5 units (group 1, n = 5) or 20 units (group 2, n = 5). Results: The masseter muscle activity of the rabbits was significantly reduced immediately after BTX-A injection (P < 0.05 for both groups). When the results from group 1 were compared with those from group 2, only the peak voltage was significantly decreased in group 2 (P = 0.013). Conclusion: Masseter muscle activity measured by EMG was immediately decreased after a BTX-A injection.

Botulinum Toxin Therapy in a Patient with HHH Syndrome with Gait Disturbance: A Case Report

  • Kim, Dong-Hyun;Choi, Yoon-Hee
    • 대한통합의학회지
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    • 제9권2호
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    • pp.105-108
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    • 2021
  • Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.

보툴리눔 톡신 주사를 위한 깨물근 얕은층의 임상해부학적 고찰 (Clinical anatomic consideration of the superficial layer of the masseter muscle for botulinum toxin injection)

  • 이형진;김희진
    • 대한치과의사협회지
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    • 제55권5호
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    • pp.365-369
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    • 2017
  • In clinical dentistry, botulinum toxin is generally used to treat the square jaw, bruxism, and temporomandibular joint diseases. Recently, this procedure has been expanded and applied for cosmetic purposes, and it is becoming a key task to be aware of the precise anatomical structure of the target muscles to be cautious during treatment and how to prevent side effects. Therefore, the purpose of this study is to observe the anatomical structure of the superficial layer of masseter muscle and to provide a most effective botulinum toxin injection method through clinical anatomical consideration. It was observed that the muscle belly of superficial part of the superficial layer was originated from the deep to the aponeurosis of masseter muscle and descend, then changed gradually into the tendon structure attaching to the inferior border of the mandible. In this study, we named this structure deep inferior tendon. This structure was observed in all specimens. We conclude that the use of superficial layer and deep layer injection should be considered to prevent paradoxical masseteric bulging in consideration of the deep inferior tendon of superficial part of superficial layer of masseter muscle.

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The Effect of Dilution with 10% Dextrose Solution on the Potency of Botulinum Toxin A

  • Ham, Jong Wook;Kwon, Jeong-Seung;Cho, Eunae Sandra;Choi, Jong Hoon
    • Journal of Oral Medicine and Pain
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    • 제44권1호
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    • pp.11-15
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    • 2019
  • Purpose: The aim of this study was to compare the potency-stabilizing effects of two different diluents of botulinum toxin A (10% dextrose solution and 0.9% saline). Methods: A mouse lethality bioassay was undertaken. Ninety mice were divided into experimental and control groups which received varying dosages in subgroups of 10. The experimental group was injected with botulinum toxin A diluted with 10% dextrose solution and the control group was injected with botulinum toxin A diluted with 0.9% saline. A 72 hours after intraperitoneal injection, the number of dead mice was counted to confirm median lethal dose ($LD_{50}$) of each group. Results: The value of $LD_{50}$ in the experimental group was approximately 0.131 mL (1.31 U) and the value of $LD_{50}$ in the control group was approximately 0.107 mL (1.07 U). The potency preservation rate of the experimental group was estimated to be 93.5% and that of the control group was estimated to be 76.3%. Conclusions: Dilution with 10% dextrose solution displayed less potency loss than 0.9% saline.

Screening for variations in anterior digastric musculature prior to correction of post-traumatic anterior open bite by injection of botulinum toxin type A: a technical note

  • Zdilla, Matthew J.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권3호
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    • pp.165-167
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    • 2015
  • It has recently been reported that long-standing post-traumatic open bite can be successfully corrected with botulinum toxin type A (BTX-A) injection into the anterior belly of the digastric muscle (ABDM). The report documented an individual with bilaterally symmetrical and otherwise unremarkable anterior digastric musculature. However, the existence of variant anterior digastric musculature is common and may complicate the management of anterior open bite with BTX-A injection. Screening for variant ABDM can be accomplished via ultrasound, computed tomography, and magnetic resonance imaging. Screening for variant ABDM should be performed prior to BTX-A injection in order to account for musculature that may exert undesired forces, such as inferolateral deviation, on the anterior mandible in patients with anterior open bite.

덴탈 프리스케일로 평가한 보툴리눔 A형 독소 반복 주사 후 근육의 약화 (Muscle Weakness after Repeated Injection of Botulinum Toxin Type A Evaluated by Dental Prescale)

  • 변영섭;송지희;최영찬;김성택
    • 구강회복응용과학지
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    • 제26권1호
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    • pp.69-75
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    • 2010
  • A형 보툴리눔 독소(botulinum toxin type A, BTX-A)는 교근 비대의 치료에 성공적으로 적용되어 왔지만 주사 부위 근육의 약화를 초래한다. 이 연구는 BTX-A를 사람 교근에 주사한 후 최대 교합력(Maximum Bite Force, MBF) 의 변화를 측정하고, 반복 주사의 효과를 평가하기 위해 시행되었다. 30명의 자원자들을 18주간 추적 관찰하고, 최대 교합력을 측정하였다. 1차 주사로부터 18주가 경과한 후 시술에 만족한 16명은 제외하고 나머지 14명에게 반복 주사를 시행하였고, 다시 18주간 측정하였다. 평균 최대 교합력은 주사 2주 후 20% 감소하였다가 4주부터 점차 회복되었으며, 12주 뒤에는 주사 이전 수준으로 회복되었다. 최대 교합력은 주사 전과 주사 2주, 4주, 8주 후에서 유의한 차이를 보였다(p<.05). 반복 주사군(n=14)의 최대 교합력은 6주에 두드러진 감소를 보였다가(p<.05) 12주간 점차 회복되었다. 실험군이 경험한 불편감의 수준은 일반적인 저작에는 거의 영향을 미치지 않았다.

교근 부위의 보툴리눔 독소 주사가 저작근의 근전도 및 악기능에 미치는 영향 (Short-term Effect of Botulinum Toxin Injection on the Surface EMG of Masticatory Muscles and Jaw Function)

  • 이정윤;박희경;정진우
    • Journal of Oral Medicine and Pain
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    • 제31권1호
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    • pp.69-77
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    • 2006
  • 저작근과 관련하여 나타나는 여러 운동장애의 치료나 심미적인 목적으로 교근 부위에 보툴리눔 독소를 주사하는 방법이 널리 이용되고 있다. 그러나 보툴리눔 독소의 교근 부위 주사가 다른 저작근의 근전도와 악기능에 어떠한 영향을 미치는 지에 대한 자료는 부족하다. 이에 본 연구에서는 측두하악관절장애 등 하악의 기능 이상을 가지고 있지 않는 건강한 성인남녀 14명을 대상으로 양측 교근에 각각 80 unit씩의 보툴리눔 독소 A(Dysport, Ipsen, Wrexham, UK)를 주사한 5 명의 실험군과 같은 위치에 같은 양의 생리식염수를 주사한 9 명의 대조군에서 주사 전과 주사 후 3 주까지 매주 교근과 전측두근의 표면 근전도를 측정하고, 국문판 악기능제한지수(Jaw Functional Limitation Scale) 설문지를 이용하여 악기능제한 정도를 평가하여 비교 분석하였다. 교근의 근전도는 실험군에서 주사 후 1주부터 감소하기 시작하여 3주 동안 지속적인 감소를 나타냈으며, 전측두근의 근전도는 유의한 변화를 나타내지 않았다. 악기능제한지수는 저작지수와 전반적 악기능 지수가 실험군에서 보툴리눔 독소 주사 후 1 주째에 증가한 뒤 점차 회복하는 양상을 보였으며, 개구지수와 대화 및 감정표현 영역 기능제한지수는 통계적으로 유의한 변화를 보이지 않았다. 이러한 결과로부터 교근에 시행하는 보툴리눔 독소 주사는 교근의 활성을 지속적으로 저하시키지만 전측두근의 활성에는 영향을 미치지 않았으며, 주관적 저작기능을 단기적으로 저하시키나, 근활성의 저하가 지속되는 과정에서도 주관적 저작기능은 짧은 기간 내에 회복됨을 알 수 있었다.

보튤리늄 독소를 이용한 보상성 다한증의 치료경험 -증례보고- (Treatment of Compensatory Hyperhidrosis with Botulinum Toxin A -A case report-)

  • 신상호;신은영;김두환;서정훈;임정길;신진우
    • The Korean Journal of Pain
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    • 제22권3호
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    • pp.253-256
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    • 2009
  • Conventional thoracoscopic sympathectomy is an effective method in treating palmar-axillary hyperhidrosis. However, this may result in a postoperatively compensatory hyperhidrosis. Conservative treatments of compensatory hyperhidrosis consist of aluminum chloride, anticholinergics, iontrophoresis, and botulinum toxin A injections. Surgical treatments in compensatory hyperhidrosis include excision of axillary tissue, liposuction, and thoracoscopic sympathectomy. Intradermal injection of botulinum toxin A has used to treat focal axillary or palmar hyperhidrosis. Botulinum toxin A bestows significant benefits with few side-effects and is well-tolerated, with beneficial results lasting from 4-16 months. We report a case illustrating the beneficial use of botulinum toxin A in a 25-year-old healthy male patient with compensatory sweating of the flank after thoracoscopic sympathectomy. Modified Minor's starch iodine test was used to allow accurate assess the impact of hyperhidrosis on the patient. In conclusion, Botulinum toxin type A is a valuable therapy for compensatory sweating after endoscopic thoracic sympathectomy.

Correction of post-traumatic anterior open bite by injection of botulinum toxin type A into the anterior belly of the digastric muscle: case report

  • Seok, Hyun;Park, Yong-Tae;Kim, Seong-Gon;Park, Young-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제39권4호
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    • pp.188-192
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    • 2013
  • Post-traumatic anterior open bite can occur as a result of broken balance among the masticatory muscles. The superior hyoid muscle group retracts the mandible downward and contributes to the anterior open bite. Denervation of the digastric muscle by injection of botulinum toxin type A (BTX-A) can reduce the power of the digastric muscle and help to resolve the post-traumatic anterior open bite. A patient with a bilateral angle fracture had an anterior open bite even after undergoing three operations under general anesthesia and rubber traction. Although the open bite showed some improvement by the repeated operation, the occlusion was still unstable six weeks after the initial treatment. To eliminate the residual anterior open bite, BTX-A was injected into the anterior belly of the digastric muscle. Following injection of BTX-A, the anterior open bite showed immediate improvement. Complication and relapse were not observed during follow-up. Long-standing post-traumatic open bite could be successfully corrected by injection of BTX-A into the anterior belly of the digastric muscle without complication.