Evaluation of the Efficacy of the Combined Therapy of Botulinum Toxin and Hyaluronic Acid Compared to Conservative Intervention in the Treatment of Chronic Peripheral Facial Paralysis of Oncologic Etiology.

Abstract

Neoplasms in the head and neck often lead to peripheral facial paralysis (PFP), impacting facial expression and causing psychological distress. Standard treatments involve physiotherapy, but botulinum toxin type A (BTA) and hyaluronic acid (HA) injections have shown promise in promoting facial symmetry. To assess the effectiveness of combined BTA and HA intervention in PFP patients, comparing it to conventional treatment (physiotherapy). A single-blind, randomized clinical trial at Hospital de Amor de Barretos included 18 patients, with the control group receiving standard therapy and the combined therapy (CT) group receiving BTA and HA. Evaluations utilized the Sunnybrook facial grading scale (SFGS) and Psychosocial Facial Asymmetry Scale (EPAF) questionnaires, along with photographic analysis. CT significantly improved facial symmetry and psychosocial aspects compared to the control group. The SFGS scores increased by 27 points in CT versus 3 points in the control group, while EPAF scores decreased by 16 points in CT and increased by 1 point in the control group. Photographic analysis showed improved dynamic smiles in CT patients. Functional gains were more evident at 30 days, with continued improvement over four months. Psychosocial scores increased throughout the study. Only two CT patients reported transient issues with drinking and chewing. The study suggests the positive impact of combined therapy on psychosocial and functional aspects, emphasizing the need for further robust research to determine its therapeutic potential. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .