• Journal of Chest Surgery
• /
• v.33 no.3
• /
• pp.268-272
• /
• 2000

Thoracic sympathicotomy has been used safely and successfully to treat essential hyperhidrosis. However, it has been difficult to treat compansatory hyperhidrosis after thoracic sympathicotomy and focal hyperhidrosis. The sweat glands were innervated by post-ganglionic sympathetic fibers with acetylcholic serving as the transmitter. Botulinum A toxin has been reported to block neuro-transmission at the cholinergic autonomic nerve terminals. Prospecting its effect for the sweat gland, we treated 5 patients with focal hyperhidrosis with botulinum A toxin. Three patients received bilateral thoracic sympathectomy (1 case) and sympathicotomy(2 case) via VAT. The hyperhidrosis area was marked with betadine and was subdivided into squares of 2$\times$2 cm(4$\textrm{cm}^2$) each. Botulinum A toxin was injected intracutaneously in a dosage of 2.5U/0.1ml(100U/4ml) /4$\textrm{cm}^2$. A total dose of 100U of Botulinum A toxin was injected into the affected sites. Subjective assessment of sweat production by the patients using a visual analogue scale showed a 20~70% improvement. During the follow-up period, no toxic effects were observed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.8 no.2
• /
• pp.199-203
• /
• 1997

In the treatment of spasmodic dysphonia, local injection of botulinum toxin A has been reported to be successful. The treatment of adductor type spasmodic dysphonia with botulinum toxin type A injection using a flexible nasopharyngoscope was conducted in 29 patients and using a telearyngoscope in 31 patients. These patients were given toxins in the vocal fold(s), unilaterally or bilaterally, under flexible nasopharyngoscopic guidance with sclerosing needle or telelaryngoscopic guidance with 23 gauge scalp needle attached by laryngeal forceps. Before the above procedure, laryngeal anesthesia was done with 2% pontocain instillation. Among the 60 patients, 59 patients were given the toxin successfully. Telephone interview were made at 2weeks and then at 4 weeks post injection. Among 29 patients using a flexible nasopharyngoscope, 75.8% and among 31 patients using a telelaryngoscope, 90.0% reported that the patients' symptom was improved. The functional status of the patient's disorder was classified into four grades. The mean pre-injection grade fir the patients using flexible nasopharyngoscope and telelaryngoscope was 1.6 and 2.1 respectively. And it was lowered to 0.7 and 1.1 respectively after the injection. The result was similar(p<0.05). As a self assessment method, the patients were asked to rate their voice on a scale of 100. In this study, the mean pre-injection score was 44 and 40 respectively. And it was improved to 77.7 and 69.8 respectively after the injection. The result was similar(p<0.05). In conclusion, botulinum toxin injection using a flexible nasopharyngoscope is also an effective method for the treatment of adductor type spasmodic dysphonia as using a telelaryngoscope.

• Archives of Plastic Surgery
• /
• v.32 no.1
• /
• pp.85-92
• /
• 2005

Botulinum toxin type A is widely used for anti-wrinkling therapy, and correction of the square face. The toxin ultimately prevent the release of membrane-bound acetylcholine at the neuromuscular junction of striated muscles and thus produce chemical denervation and paralysis of the muscles. Our purpose of study is to know if application of botulinum toxin type A on calf reduction is effective, how much dosage is effective, and what are the possible complications. We reviewed data of 30 consecutive patients subjected to calf reduction in Dong-A University Hospital from February 2003 to April 2003. We injected normal saline 2cc on both calves region in 15 control group patients, and the other patients was divided 3 group. Group 1, Group 2, Group 3 was injected 50U, 100U, 150U botulinum toxin A on each calf region and followed up for 6 month. Maximal circumference of calf was not changed in the control group but an average of 0.7 cm reduction was noted in group 1, average 1.34 cm(right calf) and 1.26cm(left calf) in group 2, average 1.44cm(right calf) and 1.58cm(left calf) in group 3. Maximal area of calf was not changed in the control group but average reduction of 12.5%(right calf) and 12.7%(left calf) was obtained in group 1, average 19.4% (right calf) and 19.9%(left calf) in group 2, average 24.8%(right calf) and 21.07%(left calf) in group 3, as measured on CAT scan. Total fat amount and fat amount in the lower extremity was no change in all the groups, but lean body mass was decreased average 1.27%(right calf) and 1.15%(left calf) in group 1, average 3.47%(right calf) and 2.98%(left calf) in group 2, average 3.58%(right calf) and 3.95%(left calf) in group 3. Photography of the preoperative and postoperative 6 month state revealed higher satisfaction in Group 2, 3 compared to Group 1. Use of botulinum toxin type A in calf reduction is a very simple, safe, non-invasive method and effective in terms of calf contouring rather than reduction of calf circumference.

• The Korean Journal of Pain
• /
• v.24 no.3
• /
• pp.164-168
• /
• 2011

Obturator nerve block has been commonly used for pain management to prevent involuntary reflex of the adductor thigh muscles. One of several options for this block is chemical neurolysis. Neurolysis is done with chemical agents. Chemical agents used in the neurolysis of the obturator nerve have been alcohol, phenol, and botulinum toxin. In the current case, a patient with spasticity of the adductor thigh muscle due to cervical cord injury had obturator nerve neurolysis done with botulinum toxin type B (BoNT-B). Most of the previous studies have used BoNT-A with only a few reports that have used BoNT-B. BoNT-B has several advantages and disadvantages over BoNT-A. Thus, we report herein a patient who successfully received obturator nerve neurolysis using BoNT-B to treat adductor thigh muscle spasm.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.29 no.4
• /
• pp.391-398
• /
• 2013

Botulinum toxin has been used for treating strabismus, blepharospasm, cerebral palsy, cervical dystonia, hyperhydrosis, facial wrinkle and chronic migraine under US Food and Drug administration approval. Also it has been tried spasticity-induced pain, post-herpetic neuralgia, myofascial pain and aphthous ulcer as off-label use. In this study, we reviewed recent studies that suggested effects of botulinum toxin on snoring and sleep apnea.

• Clinical Pain
• /
• v.19 no.1
• /
• pp.49-53
• /
• 2020

Piriformis muscle syndrome is a condition that causes direct muscle pain around piriformis muscle or sciatica from irritated sciatic nerve and the diagnosis remains debatable. The main treatment is symptomatic relief from conservative therapy such as medication and piriformis stretching exercise, and various therapeutic injections including local anesthetic, corticosteroid, botulinum toxin can be considered for diagnostic and therapeutic purposes. In this case, a 54-year-old male who had sciatica and gait disturbance showed piriformis muscle hypertrophy in the pelvis MRI. From imaging studies, electrodiagnostic study and physical examination, he was diagnosed with piriformis muscle syndrome. He underwent trigger point injection and botulinum toxin injection into the piriformis muscle, and pain and gait disturbance significantly improved. This case reports a case of piriformis muscle syndrome with clinical symptom of gait disturbance, which was improved by botulinum toxin injection.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.23 no.2
• /
• pp.171-178
• /
• 2007

Botulinum toxin type A (BTX-A) has a local effect at the neuromuscular junction by blocking acetylcholine release and thus causing paralysis and atrophy of the affected muscles. In dentistry, Botulinum toxin type A(BTX-A) is used for the treatment of masseteric hypertrophy, temporomandibular disorder, and severe bruxism related neurologic disorder. We hypothesized that the muscle atrophy after BTX-A injection into masseter muscle in growing rats, could affect the jaw growth. The purpose of this study was to determine the effects of the BTX-A injected into the masseter muscle on the jaw growth in rats. Rats were divided into four groups(group 1; control group, group 2; saline injection group, group 3; BTX-A injection group, group 4; baseline control group). Group 4 was sacrificed at the beginning of the experiment to provide baseline values of jaw measurements. The weight, length and width of jaw in those groups were measured every weeks. This study reported that the mandibular body length, condylar length, coronoid process length, anterior region height, coronoid process height and condylar height of the jaw in BTX-A injection group were shorter than those of the control and saline injection groups(P<0.05). In conclusion, BTX-A injected into the masseter muscle may affect the undergrowth of the jaw in rats.

• Archives of Plastic Surgery
• /
• v.32 no.3
• /
• pp.311-313
• /
• 2005

Generally, many Asian women tend to dislike the square jaw, as they believe it makes the face look wider, giving a stubborn and strong impression. Contouring of the mandible is therefore a relatively common aesthetic procedure among Asians. These days, the use of botulinum toxin for contouring of the lower face offer simple alternative to surgery. Motor point, which is the site over a muscle where its contraction may be elicited by a minimal intensity short duration electrical stimulus, is the optimal injection point of botulinum toxin. Study was undertaken to identify the location of motor point of the masseter muscle and the skin surface landmark. First, the thickest point of the masseter muscle was inspected through palpation and inspection by 3 different individual plastic surgeons and then compound muscle action potentials(CMAPs) of masseter muscle in 15 health volunteers were recorded using EMG. For the localization of the measured points, line between lateral canthus to the mandibular angle was used. Location of motor points were mapped to skin surface from lateral canthus in a percentage of the distance along the landmark line and in distance in millimeters. The clinical injection point was located at 71.69 percentile and 7.3 mm of the landmark line. The motor point test was located at 72.54 percentile and 7.1 mm of the landmark line. The depth of motor point was 16mm. There was no statistically significant difference between the clinical injection point and the motor point. We conclude that surface mapping of motor point of the masseter muscle would increase accessibility and accuracy in botulinum toxin injection for contouring of the lower face.

• Archives of Craniofacial Surgery
• /
• v.12 no.2
• /
• pp.125-128
• /
• 2011

Purpose: Asymmetric crying facies is caused by agenesis or hypoplasia of the depressor anguli oris muscle and is often associated various anomalies. Several static and dynamic surgical interventions have been reported, but their effects are unreliable. We report on the successful use of botulinum toxin A in an asymmetric crying facies patient. Methods: A 4-year-old girl presented with a facial asymmetry on crying or smiling. Physical examination revealed that her face had no asymmetry at rest. However, the patient showed characteristic asymmetry when smiling, crying, and with other normal facial movements. Asymmetric crying facies was clinically suspected and the weakness of left depressor anguli oris was present on electrophysiology study. Fifteen units of botulinum toxin type A were injected to the right depressor anguli oris muscle. Results: The patient showed the prominent improvement in the facial symmetry without significant complication and the effect persisted until 3 months post injection. Conclusion: Asymmetric crying facies was treated successfully with botulinum toxin A and this method was easy and noninvasive.

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