Application Of Botulinum Toxin Type Research Articles

Botulinum toxin type A in treatment of chronic migraine, spasticity and bruxism

Introduction: Nowadays, botulinum toxin has found use in many disease entities such as chronic migraine, spasticity, bruxism and many others. Among serotypes A-E, type A is mainly used in treatment. For the therapeutic effect to be maintained, injections need to be repeated most often after 12 weeks. More frequent injections of the toxin may result in the production of neutralizing antibodies. Aim of the study: The aim was to collect and analyze publications of application of botulinum toxin type A (BT-A) in the treatment of chronic migraine, spasticity and bruxism. Methods and materials: We reviewed the literature available in the PubMed database using the key words: “botulinum toxin”; “migraine”; “spasticity”; “bruxism”. Results: The use of botulinum toxin type A in patients with chronic migraine reduces the frequency of pain episodes and alleviates the symptoms. BT-A therapy reduces increased muscle tension, resulting in improved function of the upper or lower limb, facilitating the rehabilitation process, reducing pain associated with spasticity and protecting against the development of muscle contractures and secondary joint deformities. BT-A treatment of patients with bruxism reduces the level of pain and the maximum generated bite force, resulting in an improved quality of life for patients. Conclusion: Intramuscular administration of botulinum toxin is a safe, effective and minimally invasive method of treating chronic migraine, spasticity and bruxism. The botulinum toxin type A is the most studied serotype used for therapeutic purposes. Future research on botulinum toxin will certainly allow wider use.

Introduction to ECM Advances in Chinese Dermatologic Surgery.

We are pleased to present the Dermatologic Surgery Special Issue, which is focused on the extracellular matrix (ECM) in skin regeneration and dermopathy treatment. Regenerative medicine based on ECM is one of the most promising tools for skin rejuvenation and soft tissue regeneration. In addition, the occurrence of dermopathy is highly related to the disturbance of the ECM. In this issue, we provide the most recent advances in determining the role of the ECM in research and clinical application. This issue presents several articles on the cutting edge of dermatologic surgery. Dermatofibrosarcoma protuberans (DFSP) was discovered to have fibroblastic activity, and a variety of neural features were discovered, which validated DFSP’s fibroblastic origin and tendency toward neural differentiation. The efficacy and safety of picosecond laser therapy (PLT) was proven in the treatment of melasma. In addition, the efficacy and safety assessment found that the ECM is a dressing that promotes wound healing after PLT, which can shorten the downtime by alleviating erythema and edema and proceeding with scab shedding related to PLT. The treatment of keloids, a disease caused by ECM disorder, is an urgent problem in clinical practice. In this special issue, different keloid treatments are presented, including punch excision combined with drug injection, autologous split-thickness skin graft and postoperative radiotherapy, surgical excision with electron beam radiotherapy, and reduced incision tension of keloid surgery by tightening the fascia layer. The illumination of these promising strategies will be conducive to the development of future targeted therapies. Finally, we are fortunate to have several peer-reviewed literatures on the applications of ECM in skin regeneration medicine. Pingping Lin et al elucidated the dynamic composition and potential roles of the extracellular matrix in normal skin, the wound healing process, and abnormal skin scarring. Yixin Wang et al provided an overview of the clinical research, limitations, and potential application of botulinum toxin type A in the prevention and treatment of traumatic or postoperative scars. Weiyuan Zhang et al investigated the mechanism of Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) in reducing inflammation, promoting angiogenesis, promoting the proliferation and migration of epithelial cells and fibroblasts, and ECM remodeling during wound healing.

Osteoarthritis of the hip conservative treatment with type A botulinum toxin.

Osteoarthritis (OA) of the hip is a low-grade inflammatory disease of multiple etiology that has a limited conservative management and insufficiently explored. The application of botulinum toxin type A (BoNT-A) produces in the applied muscle a temporary, delimitable and reversible flaccid paralysis, which applied in a strategic way achieves to reduce mechanical stress and pain. To evaluate the effect on pain perception, functionality and rigidity and changes in flexibility, internal and external rotation, before and 90 days after the application of BoNT-A. Clinical, experimental, longitudinal, open study, with a total of 35 patients and 45 hips treated. BoNT-A of 500 U was applied in iliac, adductor brevis and longus muscles. The Wilcoxon test was used to compare the evaluation scores on days 0-90, observing the decrease in referred pain (p < 0.0001), rigidity (p < 0.002), improved perceived function (p < 0.001) and mobility arcs: flexion, internal and external rotation (p < 0.0001). The treatment with BoNT-A provides a conservative and safe option for the management of symptoms and physical restraint caused by hip OA.

Topical application versus intraturbinate injection of botulinum toxin type A in the treatment of noninfectious chronic rhinosinusitis

Background Chronic rhinosinusitis is a very common disorder caused by chronic inflammation or irritation of nasal mucosa. Objectives The purpose of this study was to evaluate the efficacy and safety of topical application of botulinum toxin type A (BTX-A) compared with intraturbinate injection for the treatment of noninfectious chronic rhinosinusitis. Patients and methods This prospective comparative study was carried out on 30 patients with noninfectious chronic rhinosinusitis. Patients were divided randomly into two groups. BTX-soaked merocel was applied topically in group A (topical group), which included 15 patients. Intraturbinate BTX injection was applied in group B (injected group), which included 15 patients. The total nasal-symptom score (TNSS) was applied initially and after the procedure for 8 weeks of follow-up period. Results Both groups showed significant improvement of the TNSS all over the period of the study compared with the baseline, except at the eighth week in group A (topical group). At the eighth week, the TNSS was significantly higher in group A than group B, median (range) of 8 (4–11) compared with 5 (3–6), P value was less than 0.001. No one complained from epistaxis and only three patients in group B reported nasal-dryness sensation at the fourth and sixth weeks and improved by the eighth week. Conclusion BTX-A topical application using soaked merocel could be a safe and a very successful way for managing the symptoms of chronic noninfectious rhinosinusitis. However, injections had a longer duration of impact than topical application.

Our Experience in the Application of Botulinum Toxin Type A in Medically Resistant Chronic Migraine Patients

Amaç: Botulinum toksini tip A, kronik migrenin önleyici tedavisi için iyi tolere edilen bir seçenek olarak kabul edilmiştir. Bu çalışmanın amacı, kronik migren tedavisinde botulinum toksin uygulamasının baş ağrısı atak sıklığını, atak şiddetini ve uygulama sayısı artıkça etkinliğinin nasıl olacağını değerlendirmektir. Gereç ve Yöntemler: Medikal tedaviye dirençli kronik migren hastalarından üç ay arayla botulinum toksin A yapılmış hastalardan toplam 29 hastanın verisi toplandı. Demografik verileri, tedavi öncesi aylık atak sıklığı, atak şiddeti, ilacın etkinlik süresini karşılaştırıldı. Bulgular: Botulinum toksini tip A uygulama öncesi ile üçüncü uygulama sonrası karşılaştırıldığında, migren ataklarının aylık sıklığında (21.7 'e karşı 11.4 gün) ve Nümerik derecelendirme skorunda (9.2 'e karşı 5.6) önemli ölçüde iyileşme bulundu (p&amp;lt;0.001). Botulinum toksin etkinliğinin süresi ilk uygulama sonrasında ortalama 3 ay 18 gün, ikinci uygulama sonrasında 3 ay 7 gün, üçüncü uygulama sonrasında 4 ay olarak bulundu. Sonuç: Bu çalışma, Botulinum toksini tip A uygulanan kronik migrenli hastalarda baş ağrısı atak sıklığında ve şiddetinde azalma gösterdi. Uygulama sayısı artıkça hastaların ağrısız gecen sürelerinde de artış bulundu.

BOTULINUM TOXIN FOR CORRECTION OF GINGIVAL SMILE

The gingival smile is an aesthetic concern that affects a large portion of the population, an aesthetically acceptable smile must be harmonious as to the set of teeth, lips and gingival tissue. When the etiological factor is muscle hyperfunction, a treatment option is the application of botulinum toxin type A in the muscles responsible for lifting the upper lip, so the objective of this case report is to demonstrate the use of botulinum toxin to correct gummy smile. . Female patient, age 32, Phototype II, sought care at the Specialization Clinic in Orofacial Harmonization of the IOA-IOP, Campina Grande-PB, due to excessive gingival exposure when smiling. After clinical evaluation, it was observed that the patient had hyperactivity of the levator labii superioris muscles and a gingival exposure of 4 mm. It was proposed to the patient the application of botulinum toxin for the treatment of gummy smile and then the Free and Informed Consent Term was signed specifying all possible complications that could happen, as well as the benefits and results. After the photographs and demarcations, 2 units were applied to the levator labii superioris muscle bilaterally and 2 units to the nasal septum. After 15 days of application, the patient was reassessed, demonstrating an excellent result without excessive exposure of the gingiva and there was no need for a new application. It was concluded that TBA brought a very satisfactory result for the correction of the gummy smile and constitutes a safe and effective treatment.

The Effect of Different Treatment Methods on Acute Acquired Concomitant Esotropia.

Objective The application of botulinum toxin type A (BTXA) in the treatment of paralytic strabismus has been recognized, but there are few studies on the treatment of acute acquired comitant esotropia (AACE). This study was aimed to investigate the clinical characteristics of AACE and compare the therapeutic effects of BTXA and traditional surgery. Methods 78 patients with AACE in Renmin Hospital of Wuhan University between March 2019 and March 2021 were reviewed. The relevant medical records of the patients were collected, and they were divided into surgical group (n = 46) and botulinum toxin type A (BTXA) group (n = 32) according to different treatment approaches. The surgical group was treated with squint correction, whereas the BTXA group was treated with microinjection of BTXA in MR. Eye alignment, esotropia, stereopsis, and complications were examined before and after treatment in both groups. Results The refractive status of 78 patients with AACE was mostly myopic refractive error. In general, the angle of esotropia at distance was larger than which at near, with a statistically significant difference. At follow-up assessments of 1 week, 1 month, 3 months, and 6 months after treatment, the total effective rates of the surgical group and the BTXA group were 100% and 90.48%, respectively. The residual angle of esotropia of both groups was lower after treatment. Additionally, the incidence rate of complications in the BTXA group was significantly lower than that in the surgical group. Conclusion AACE occurs mostly in people with myopic refractive errors and is associated with prolonged near work. Besides surgical treatment, micro-injection of BTXA is also an effective and safe treatment for AACE.

Research advances on application of botulinum toxin type A in scar prevention and treatment

The wound healing time, tension of wound edge, proliferation of fibroblast, and extracellular matrix deposition are the important factors of scar formation, and botulinum toxin type A can regulate the above. Prevention and treatment of scar with botulinum toxin type A is one of the hot topics of clinical research in recent years. This paper briefly reviews researches by scholars at home and abroad on the mechanism, clinical application, complications, and adverse effects of botulinum toxin type A in scar prevention and treatment.

Aesthetic implications of depressor supercilii muscle block with botulinum toxin type A.

When applying botulinum toxin in the upper third of the face, it is important to consider the balance between the elevator and depressor muscles of the eyebrows. Depressor supercilii muscle block leads to elevation of the medial portion of the eyebrow and correction of the oblique lines in the frown. The intention is to highlight the importance of the depressor supercilii muscle block as a useful tool to reposition the medial portion of the eyebrow. Three cases are presented, in whom botulinum toxin is applied conventionally and subsequently on the depressor supercilii muscle after the subjective sensation of flattening of the glabella and increasing distance between the eyebrows referred by the patients. The application of botulinum toxin type A on the depressor supercilii muscle is an effective measure to facilitate the elevation of the medial portion of the eyebrow, after the conventional application in between the eyebrows treating the orbicularis, corrugator, and procerus muscles. Depressor supercilii muscle block can be considered when applying botulinum toxin type A in the upper third of the face, in cases where there is loss of facial aesthetic harmony. This is given by the subjective perspective of the patient due to a change in the natural expression of their face with a sensation of flattening of the glabella and distancing of the medial portion of the eyebrows, occurring after the use of a conventional technique at that anatomical level, where patients may report a "feline" or "avatar" appearance.

Histological and mast cells evaluation after application of botulinum toxin type a in masseter muscles of rats.

Botulinum Toxin Type A (BTX-A) has been largely used to reduce muscle strength of masseter and temporal muscles by producing a temporary weakening of their activity. This study aimed to evaluate the histological changes and the number of mast cells after the injection of BTX-A. In the masseter muscle of rats in the periods of 1, 7, 15, and 30 days. These muscles were stained with hematoxylin and eosin (H&E) and toluidine blue (TBO). The presence or absence of an inflammatory process and necrosis were analyzed by H&E in all area of the slide at 10X magnification. The number of mast cells was evaluated by counting 10 "hotspots" in the intra-muscular region on TBO-stained slides, 400X magnification. Statistical analysis was performed through two-way analysis of variance and Tukey's test. As a result, the inflammatory process and necrosis were not observed in any periods studied in both groups Regarding mast cells, there was no statistically significant increase in their quantity in the study group when compared to the control group in the evaluation periods of 7 days and 15 days. However, these mast cells increased significantly during the periods of 1 and 30 days. This study showed that even in the absence of an inflammatory process, there was an increase in the number of mast cells in the first 24 hours after the application of BTX-A, with a subsequent balance between the numbers of mast cells at 7 and 15 days, and again an increase after 30 days. Key words:Botulinum toxins type A, mast cells, masseter muscle.

INTERCORRENCES WITH THE MISUSE OF TYPE A BOTULINUM TOXIN

Botulinum Toxin type A has become a great ally in aesthetic procedures because it is a very efficient non-surgical, aesthetic-therapeutic procedure. Known and much sought after for the result it provides in facial harmonization, by smoothing expression lines caused by repeated contractions carried out over the years, it has increased the demand for the technique, and with that, some complications and light, but transient complications arose. Thus, the objective of this article is to understand the process of application of botulinum toxin type A, its effects and complications (intercurrences) that may arise when not performing the technique as recommended, in addition to reviewing the literature and the protocol for applying the Botulinum toxin type A. The bibliographic research method, literature review of articles from the year 2000, in English and Portuguese, in search platforms of Scielo, Pubmed, Academic Google, atlas, dissertations and theses. Respecting the reapplication time is essential not only for complications, but also the patient's individuality, outlining a safe and effective path to avoid unwanted effects, thus ensuring a successful and attractive procedure both in the eyes of the professional and in the eyes of the clients .

Clinical Application of Botulinum Toxin Type A in Cosmetic Facial Injection

Clinical Application of Botulinum Toxin Type A in Cosmetic Facial Injection

The Central Effects of Botulinum Toxin in Dystonia and Spasticity.

In dystonic and spastic movement disorders, however different in their pathophysiological mechanisms, a similar impairment of sensorimotor control with special emphasis on afferentation is assumed. Peripheral intervention on afferent inputs evokes plastic changes within the central sensorimotor system. Intramuscular application of botulinum toxin type A (BoNT-A) is a standard evidence-based treatment for both conditions. Apart from its peripheral action on muscle spindles, a growing body of evidence suggests that BoNT-A effects could also be mediated by changes at the central level including cerebral cortex. We review recent studies employing electrophysiology and neuroimaging to investigate how intramuscular application of BoNT-A influences cortical reorganization. Based on such data, BoNT-A becomes gradually accepted as a promising tool to correct the maladaptive plastic changes within the sensorimotor cortex. In summary, electrophysiology and especially neuroimaging studies with BoNT-A further our understanding of pathophysiology underlying dystonic and spastic movement disorders and may consequently help develop novel treatment strategies based on neural plasticity.

Effect of botulinum toxin treatment in patients with bruxism and orofacial pain - randomized double-blind clinical trial

Introduction: Bruxism is defined as a parafunctional chewing activity characterized by the clenching and / or grinding of teeth that occurs both during sleep and during the surveillance period. Methods: Thirty female patients between 18 and 40 years old who had bruxism and orofacial pain were selected and randomized into two groups: control group (n = 15), where individuals received 0.05 ml of sterile saline solution that was applied to the bundle anterior temporal muscles and 0.2 ml for each masseter muscle, and an experimental group (n = 15), individuals received 20 units of A-botulinum toxin (Botox®) applied to each masseter muscle and 5 units of A-botulinum toxin applied to the anterior bundle of each temporal muscle. Patients were called back for reevaluation every thirty days. At these moments, they underwent an evaluation of the load force and electromyography. Results: At 30, 60, 90 and 120 days, a decrease in electromyographic activity was observed in the A-botulinum toxin group (p &lt;0.001). In the experimental group, the left masseter muscle showed no significant difference between the variable load cell and time (p = 0.968), nor between electromyography versus load (p = 0.072), with a statistically significant difference between time and electromyography. (coef = 0.322; p &lt;0.001). Conclusion: The intramuscular application of botulinum toxin type A in patients with bruxism has proved to be an effective method for hyperactivity of the masseter muscle in patients with bruxism, improving and decreasing the levels of muscle contraction.

An enhanced transcutaneous delivery of botulinum toxin for the treatment of Hailey-Hailey disease.

Successful treatment of Hailey-Hailey disease with intradermal botulinum toxin injections has been previously reported. The main disadvantages of this treatment are the excruciating pain and the risk of infections due to the numerous injections. We sought to evaluate the clinical effectiveness and safety profile of a novel approach using an energy-based device (Tixel, Novoxel, and Israel), followed by the topical application of botulinum toxin Type A for the treatment of Hailey-Hailey disease. A retrospective study of all cases of histologically diagnosed cases of Hailey-Hailey disease treated with Tixel device followed by topical application of botulinum toxin between 2018 and 2019 was performed. Epidemiologic, clinical, and treatment data, including effectiveness score and safety, were reviewed. The study included eight patients, of whom seven patients (87.5%) showed good or partial response. No systemic or local adverse effects were reported. There was no difference in effectivity between different body areas. Response to treatment ranged between patients with an average duration of 7.125 months after the second treatment. Tixel treatment followed by topical application of botulinum toxin can be considered in the treatment of Hailey-Hailey disease. This approach is less invasive, less painful, and yet effective as well as safe.

Early Postoperative Application of Botulinum Toxin Type A Prevents Hypertrophic Scarring after Epicanthoplasty: A Split-Face, Double-Blind, Randomized Trial.

Postoperative hypertrophic scarring of the medial canthal area is a common phenomenon and deterrent for patients considering epicanthoplasty. Botulinum toxin type A has been reported for hypertrophic scar and keloid treatment. However, there is a lack of high-level evidence regarding the effects of botulinum toxin type A in the medial canthal area. In this split-face, double-blind, randomized trial, 43 consecutive consenting patients undergoing Park Z-epicanthoplasty were randomized to receive 5 U of botulinum toxin type A or the same volume of saline injections at days 6 to 7 postoperatively. Scars were assessed independently using the Vancouver Scar Scale, the visual analogue scale, and patient satisfaction rating at the 1-, 3-, and 6-month follow-ups. Overall, 30 patients completed this trial. The botulinum toxin type A-treated side achieved significantly improved Vancouver Scar Scale scores. The most obvious improvements were observed at the 3-month follow-up visit. Among the four subscores of the Vancouver Scar Scale, the most significantly improved subscores were the height and pliability. The visual analogue scale scores also decreased significantly on the botulinum toxin type A-treated side at all three follow-up visits. Approximately 86.7 percent of the patients were satisfied with the scar and epicanthoplasty outcomes. No severe complications were reported. Early postoperative botulinum toxin type A injection in the medial canthal region efficiently reduces hypertrophic scarring and improves the outcome of epicanthoplasty. Therefore, botulinum toxin type A injection can be used as a routine method to prevent hypertrophic scarring and improve the outcome of epicanthoplasty. Therapeutic, II.

Tratamiento conservador de la osteoartrosis de cadera con toxina botulínica tipo A

Osteoarthritis (OA) of the hip is a low-grade inflammatory disease of multiple etiology that has a limited conservative management and insufficiently explored. The application of botulinum toxin type A (BoNT-A) produces in the applied muscle a temporary, delimitable and reversible flaccid paralysis, which applicated in a strategic way achives to reduce mechanical stress and pain. To evaluate the effect on pain perception, functionality and rigidity and changes in flexibility, internal and external rotation, before and 90 days after the application of BoNT-A. Clinical, experimental, longitudinal, open study, with a total of 35 patients and 45 hips treated. BoNT-A of 500 U was applied in iliac, adductor brevis and longus muscles. The Wilcoxon test was used to compare the evaluation scores on days 0-90, observing the decrease in referred pain (p < 0.0001), rigidity (p < 0.002), improved perceived function (p < 0.001) and mobility arcs: flexion, internal and external rotation (p < 0.0001). The treatment with BoNT-A provides a conservative and safe option for the management of symptoms and physical restraint caused by hip OA.

Application of botulinum toxin type A in gummy smile: case report

ABSTRACT Gummy smile is one of the major complaints of patients, due to its influence on the self-esteem. It is known that it has a multifactorial cause and can be present in the excessive vertical growth of the maxilla, excessive labial contraction, short upper lip and extrusion of the anterior teeth. The use of the botulinum toxin can be associated with additional treatments or be applied individually, according to the need of each patient. The goal of this research study was to present a clinical case using botulinum toxin type A as an alternative therapy to correct the gummy smile. A 22-year-old patient, presenting vertical maxillary growth, reporting aesthetic discomfort while smiling, chose for an alternative treatment therapy with the application of botulinum toxin to correct the accentuated gingival display. The results show that the toxin is a satisfactory treatment option and its indication is considered a fast, effective, easy and safe treatment method, being a more conservative approach compared to surgical procedures.

Hailey–Hailey disease − botulinum toxin type A treatment

Hailey–Hailey disease, also known as familial chronic benign pemphigus, is characterized by flaccid blisters and erosions, especially in the axillary and inguinal areas. Friction associated with local factors, such as heat, moisture, microbial colonization, and secondary infections induce the typical appearance of the lesions, especially in intertriginous areas. Traditionally the treatment is done with corticosteroids associated with topical or systemic antibiotics. We report the case of a patient with the disease presenting in the inguinal region, which has made use of different conventional drug treaments for 20 years without results. It was a proposed treatment with application of botulinum toxin type A showing significant improvement after about 20 days. The satisfactory response has been linked to the decreased local sweating caused by botulinum toxin. It would lead to a less local irritation factors and lower colonization of microorganisms.

Dose and efficacy of botulinum toxin in pediatric patients with spasticity

To evaluate the effectiveness of botulinum toxin in the treatment of upper and lower limb spasticity in pediatric patients in a real clinical setting. A retrospective study was conducted based on information from clinical records of 79 pediatric patients with spasticity in different clinical forms and severity treated with botulinum toxin type A. The improvement of rigidity and mobility was estimated by the attending physician through physical examination, evaluating the gait, rating on the Ashworth scale and measurement of joint mobility angles using a goniometer. The number of injections, the interval between them, the site of application and the dose were recorded, considering the reduction of at least one point on the Ashworth scale or an increase in the degrees of joint mobility as treatment response. Patients received injections in a mean of 10 ± 7 muscles at intervals of 4 to 50 weeks (average: 13 ± 9 weeks). A 90% also received rehabilitation. The knee, ankle and wrist showed presented a higher percentage of improvement. An improvement in the degrees of movement was found in 24% of patients. The application of botulinum toxin type A was effective for the treatment of spasticity in the pediatric population.