Botulinum Toxin A- A valuable adjunct in improving the esthetic outcomes of surgically treated cases of unilateral primary cleft lip

Abstract

In the surgical correction of the cleft lip, the surgeon faces numerous challenges which make the task of obtaining appreciable esthetic results an arduous one. A multitude of problems can present to the surgeon after the surgical repair of cleft lip, such as hypertrophic scar, peaking and notching. In such a scenario Botulinum Toxin A can help achieve improved esthetic results. Botulinum toxin type A is a powerful neurotoxin which is produced by the anaerobic organism Clostridium Botulinum and when injected into a muscle causes interference with the neurotransmitter mechanism producing selective, transient paralysis of the muscle, which in turn reduces scar contracture. Aims: To evaluate the esthetic outcome of Botulinum Toxin A injection in cleft lip surgeries and to evaluate the role of Botulinum toxin A in unilateral cleft lip scars. Materials and Methods: 30 healthy unilateral cleft lip patients reporting for cleft procedure were taken up for the study. 6-8 units of Botulinum Toxin A was injected (after test dose) along pre-determined points. Both objective (Photographic evaluation) and subjective (Patient questionnaire method) evaluation was carried out after 1 year. Results: Photographic evaluation revealed that majority of the patients had either excellent or good esthetic outcomes. Scar characteristics were evaluated and most patients were happy or very happy with the surgical results. Keywords: Botulinum Toxin A, Esthetic evaluation, Primary cheiloplasty, Subjective evaluation, Unilateral cleft lip