Abstract
It is well-established that botulinum toxin (BT) injections improve quality of life in patients with postparalytic hemifacial spasm. Nevertheless, injection-related pain and contracture-related pain have not yet been studied. The primary objective of our study was to evaluate injection-related pain in patients with facial palsy sequelae, and to compare the standard technique (syringe) with the Juvapen device. The secondary objective was to evaluate the improvement of contracture-related pain one month after BT injection. Methods: We conducted an observational, prospective, monocentric study based on 60 patients with facial palsy sequelae who received BT injections in our university ENT (ear, nose throat) department. There were 30 patients in the Juvapen group (J) and 30 in the standard technique group (ST). All patients completed Numerical Rating Scale (NRS) questionnaires immediately after the injections and one month later. Results: The average NRS score was 1.33/10 with Juvapen and 2.24/10 with the standard technique (p = 0.0058; Z = 2.75). In patients with contracture-related pain, the average NRS score was 3.53 before BT injection, and 0.41 one month after BT injection (p = 0.0001). Conclusions: Juvapen is a less-painful injection technique than the standard one. BT reduces contracture-related pain one month after injection.
Highlights
Peripheral facial palsy incidence is about 0.2 per 1000 per year
Thirty patients were injected with the standard technique (ST) and 30 patients were injected with the Juvapen device (J)
It is well known that Botulinum toxin (BT) injections allow symmetrization and reduce postparalytic hemifacial spasm
Summary
Peripheral facial palsy incidence is about 0.2 per 1000 per year. One third of patients with peripheral facial palsy do not fully recover and have chronic sequelae, postparalytic hemifacial spasm [1]. Facial palsy has a major psychosocial impact on patients [2]. Botulinum toxin (BT) injections reduce synkinesis, contractures and spasms on the affected side, and allow symmetrization of the healthy side by reducing contralateral hyperactivity. We have observed that BT injections may reduce contracture-related pain, but to our knowledge, this has never been described in the literature. BT injection-related pain in patients with facial palsy has never been studied
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