Effect Of Botulinum Toxin Injection Research Articles

Onabotulinum toxin injections for shoulder and chest wall muscle pain in breast cancer survivors: retrospective study – preliminary report

ObjectivesThe primary objective of this retrospective review is to describe patient-reported improvement in muscular pain after initial treatment with onabotulinum toxin. A secondary objective was to determine other physiatry (physical...

Functional and esthetic effects of botulinum toxin injection into the masseter muscles: evaluation of 80 patients from a dermatological perspective.

Masseter muscle hypertrophy is characterized by a symmetrical or asymmetrical increase in muscle volume. Although it can be asymptomatic, it may be associated with bruxism. Therefore, patients may seek intervention for esthetic and/or functional concerns. This study aimed to establish patient characteristics, purpose of undergoing botulinum toxin injection into the masseter muscles, efficacy, and side effects of the procedure at a dermatology clinic. A retrospective chart review was carried out over a period of one year from January 2022 to January 2023 for the patients who underwent botulinum toxin injection into the masseter muscles. The general characteristics of patients, the purpose of botulinum toxin treatment, relief levels regarding bruxism according to the Visual Analog Scale (VAS), side effects, and complications were recorded. The study group comprised 74 female and 6 male patients with a mean age of 31.20 ± 6.71 years. Eighteen (22.5%) patients were treated only for narrowingthe lower face contour, 28 (35%) patients were treated only for the relief of bruxism, and 34 (42.5%) patients were treated for both indications. Fifteen (18.8%) patients experienced 16 treatment-related side effects, including two (2.5%) with smile asymmetry and two (2.5%) with paradoxical bulging. Botulinum toxin injection into the masseter muscles with the intention of lower face contouring and/or relieving bruxism offers a minimally invasive, safe, and effective treatment option. Although it has a favorable safety profile, the risks of significant side effects or complications remain.

Effectiveness of Botulinum Toxin Injection With Casting in Children With Spastic Cerebral Palsy: A Randomized Controlled Trial

Effectiveness of Botulinum Toxin Injection With Casting in Children With Spastic Cerebral Palsy: A Randomized Controlled Trial

Three-Dimensional Photography for Evaluating the Effectiveness of Botulinum Toxin Injection for Masseter Hypertrophy.

Masseter hypertrophy is a common condition that causes a undesirable square face, and often treated with botulinum toxin type A (BoNTA). Subjective assessments of BoNTA effectiveness vary from physician to patient, necessitating an objective approach for evaluation. This study introduces three-dimensional photography (3DP) for the first time in clinical assessment to evaluate BoNTA treatment for masseter hypertrophy. Ten patients received 36U of BoNTA at three injection points on each side masseter muscle. 3DP scanner using Artec Eva® was taken at the first, third, and sixth postoperative months for objective evaluation. Patient's self-perceived prominence, patients self-rated satisfaction, and physicians provided 5-grade scores were the subjective indicators. A significant decrease in left masseter volume at the sixth month (P = 0.002, P = 0.004 at rest and clenching, respectively) was observed. Patient's self-perceived prominence decreased at the first (P = 0.021) and third (P = 0.039) months. Physicians' scores significantly decreased at all postoperative months. No significant changes were noted in the right masseter volume and patients self-rated satisfaction. Patient self-rated satisfaction did not consistently correlate with objective measures, except for left masseter with clenching at the sixth month. Three-dimensional photography accurately quantifies facial changes post-BoNTA treatment. Despite objective improvements, patient satisfaction may not align consistently. Reliable assessment tools are crucial in cosmetic surgery to manage expectations and prevent disputes. 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 .

Effectiveness of botulinum toxin injections into the obliquus capitis inferior muscle for spasmodic torticollis

Effectiveness of botulinum toxin injections into the obliquus capitis inferior muscle for spasmodic torticollis

Effect of Botulinum Toxin Injections in the Treatment of Spasticity of Different Etiologies: An Umbrella Review.

Spasticity is a very common neurological sequelae that significantly impacts the quality of life of patients, affecting more than 12 million people worldwide. Botulinum toxin is considered a reversible treatment for spasticity, but due to the large amount of available evidence, synthesis seems necessary. Therefore, we conducted an overview of existing systematic reviews and meta-analyses to evaluate the effect of botulinum toxin injections in the treatment of spasticity of different etiologies. A systematic search of different databases, including Pubmed, Scopus, the Cochrane Library, and Web of Science, was performed from inception to February 2024. Standardized mean differences (SMDs) and their respective 95% confidence intervals (CIs) were calculated to assess the effect of botulinum toxin compared to that of the control treatment using the Modified Ashworth Scale (MAS). All the statistical analyses were performed using STATA 15 software. 28 studies were included in the umbrella review. The effect of botulinum toxin injections on spasticity, as measured by the MAS, was significantly lower in all but three studies, although these studies also supported the intervention. The SMDs reported by the meta-analyses ranged from -0.98 to -0.01. Botulinum toxin injections were effective at treating spasticity of different etiologies, as indicated by the measurements on the MAS. This implies an improvement in muscle tone and, consequently, in the patient's mobility and quality of life.

Ultrasound-guided botulinum toxin injections of salivary glands in cerebral palsy children with sialorrhea

Objective: Excessive salivation and drooling are distressing problems that affect both children and their families. Salivary gland botulinum toxin injection is a widely studied therapeutic method for treating sialorrhea. The proper protocol for such treatment modality is an area of interest for researchers. This study set out to assess the success of ultrasound-guided botulinum toxin injections in either the submandibular or combined with parotid salivary glands for children with cerebral palsy suffering from sialorrhea, while also identifying factors that predict a positive treatment outcome. Method: This cross-sectional study included 30 children with cerebral palsy who have Sialorrhea. Ultrasound-guided botulinum toxin injections of submandibular salivary glands alone or combined with parotid glands were done. Drooling was evaluated using Drooling Rating Scale, Drooling Impact Scale, and 5-minute Drooling Quotient. Children were followed up weekly for 12 weeks after botulinum toxin injections. Result: All children showed a significant decline in drooling and sufficient caregivers’ satisfaction for the first 8 weeks after botulinum toxin injections, with gradual worsening of drooling later in 60% of children. Assessment scores were significantly lower in those who received combined parotid and submandibular injections than those who received submandibular gland injections alone. Changes in drooling scores have a significant negative correlation with the severity of motor disabilities. Conclusion: Submandibular salivary gland injection alone has a satisfactory response in decreasing drooling in children with cerebral palsy. However, a combined injection of both parotid and submandibular salivary glands gives a better response for at least 8 weeks without complications. This study not only addresses the clinical effectiveness of botulinum toxin injections in managing sialorrhea in children with cerebral palsy but also opens avenues for improved dietary strategies. Keywords: botulinum toxin; salivary gland; sialorrhea; cerebral palsy

The Effectiveness of Botulinum Toxin Injections to Treat Post-Stroke Arm Dysfunction

This review was written to determine the effectiveness of Botulinum Toxin (BoNT) as a treatment for upper extremity dysfunction in post-stroke patients. As most patients survive a stroke, many are burdened with disability and impaired limb function. Seventy percent of stroke patients experience motor dysfunction in the arm, with thirty percent of patients suffering from upper extremity spasticity. Spasticity is a speed-dependent condition where certain muscles are abnormally stiff, resulting in involuntary contraction when the spastic muscle is used. BoNT treatment includes injections in localized muscles and is primarily used to treat spasticity by temporarily paralyzing the injected muscle. Seven systematic reviews/meta-analyses and ten randomized-controlled trials were used to determine the effectiveness of BoNT in post-stroke patients. Overall, BoNT is effective in reducing spasticity and may be effective in reducing pain. However, its ability to improve motor function is still unclear. In addition, there is mixed evidence on the most effective way to administer BoNT treatment, such as the proper dosage or combining BoNT with another therapy. The treatment’s effectiveness is well documented in the chronic stage of stroke but less so in the acute and subacute stages. More research is needed to determine the potential adverse effects of long-term exposure to BoNT and the most appropriate dose to administer.

Effect of botulinum toxin injection on clinical and instrumental measures of walking ability in post-stroke patients with equinus foot deviation. A prospective cohort study

Effect of botulinum toxin injection on clinical and instrumental measures of walking ability in post-stroke patients with equinus foot deviation. A prospective cohort study

Comparison of the Effect of Botulinum Toxin Injection Under Ultrasound Guidance and Oral Propranolol in the Treatment of Moderate to Severe Essential Hand Tremor

Comparison of the Effect of Botulinum Toxin Injection Under Ultrasound Guidance and Oral Propranolol in the Treatment of Moderate to Severe Essential Hand Tremor

The Effect of Botulinum Toxin Injection in Cleft Lip Repair

Background & Objectives: Cleft lip and palate are common congenital anomalies that require precise management with main component of repairing lip is the aesthetic outcome. Using botulinum toxin is new method to optimize the resultant scar. The aim of this study is to evaluate the effect of botulinum toxin type A following cleft lip repair on resultant quality of scar. Methods: This is a comparative study conducted in Rizgary teaching hospital and private hospitals in Erbil – Kurdistan region/Iraq between July 2018 and April 2021. A total of 38 patients with cleft lip were included; bilateral and unilateral, complete and incomplete, isolated cleft lip and cleft lip and palate, 20 of them received botulinum toxin injection. Preoperative and postoperative photos were documented. Scars were analysed one year following repair. Results: Among 38 patients, in comparison of outcome of using botulinum toxin (31.6%) following cleft lip repair to patients did not receive the injection (68.4%), the scar quality was better; linear scar in botox group 100%, non-botox group 80.8%, complications were less; early complications in botox group 8.3%, non-botox group 11.5% and late complications in botox group 0% non-botox 7.7% and satisfaction was better; parents of botox group were 100% highly satisfied while for those of non-botox group 84.6% highly satisfied, 7.7% satisfied and 7.7% unsatisfied. There was significant difference between the two groups but statistically not significant. Conclusion: Botulinum toxin injections into the subjacent orbicularis oris muscle following cleft lip repair produced better appearing and narrower cheiloplasty scars.

A review on bigonial width reduction by botulinum toxin injections in masseter.

It is of interest to study the efficacy of botulinum toxin injection in masseter reducing bigonial width of the face. Online databases such as PubMed, Cochrane Library, Google Scholar, Science Direct database and ResearchGate were searched from initiation until October 2022 using keywords such as "masseter muscle injections", "botulinum toxin," "bigonial width reduction," "masseter muscle hypertrophy," and "lower face contouring" All available retrospective as well as prospective studies, were included with specific weightage to the efficiency of Botulinum Toxin (BT) injection in masseter muscle and the technique, unfavorable events, and the extent of its effects. A total of 20 publications were acknowledged. All prospective studies were included. Relevant data on patient selection, injection methods, efficiency, dose, rate of recurrence, and significant side effects of BT injections in masseters were collected. All excluding one were prospective studies. Bilateral injections were used in all the studies. Follow up period was 3-48 months. This systematic review focuses on the effectiveness of Botulinum toxin injection in lowering the bigonial width by decreasing the volume of the masseter. Repeat treatment at regular intervals is advisable to maintain desired results. The procedure was carried out in an office environment and was completed within 15 mins. There are no permanent adverse events related to the procedure. Further studies involving randomized control trials with larger sample sizes are warranted to optimize the dose and frequency of BT injection.

Can medical aesthetic treatments improve mental health?

Can medical aesthetic treatments improve mental health?

Effectiveness of Botulinum Toxin Injection on Bruxism: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

The present study compiled evidence on the efficacy of botulinum toxin A (BTX) for management of bruxism. A literature review that included randomized control, cohort, as well as observational studies published between January 2000 and November 2022 was conducted. All studies related to BTX injections administered into the masseters of patients with bruxism were included. Primary outcomes were measured by performing a meta-analysis of changes in maximal biting forces and pain severity and meta-regression of the effects of the BTX dose. Ten studies were included for quantitative analysis. The analysis of the maximal biting force after BTX injections demonstrated a significant reduction at 1 month or less compared with both oral splints (P < 0.000001) and saline injections (P = 0.01). BTX continued to outperform oral splinting (P = 0.001) and saline placebos (P = 0.03) at 3 months. Between 3 and 6 months, a significantly higher maximal biting strength was observed in the BTX group than the oral splinting group (P < 0.00001). No significant differences in the maximal biting force were observed between the BTX and saline placebo groups (P = 0.50). A similar trend was observed in the analysis of pain reduction after botulinum treatment. Additionally, for every unit increase in the BTX dose, pain severity decreased by 0.0831 points (P = 0.0011). BTX is effective in reducing biting strength and pain severity. BTX effects are evident at less than 4 weeks, peak between 5 and 8 weeks, and last for up to 24 weeks. Higher BTX doses result in greater improvement in pain. Although BTX benefits manifest earlier, they gradually diminish, and oral splinting exerts a more enduring effect, especially after 9-12 weeks. BTX injections into masseters are recommended as management options for bruxers, especially for those having difficulties complying with wearing oral splints or those seeking earlier symptom relief. However, future studies should determine BTX effects beyond 24 weeks and after repetitive injections and how bruxers of different ages or genders respond to treatment. 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 .

Effect of botulinum toxin injection on pain severity and quality of life among patients with postherpetic neuralgia

Background: Herpes zoster and postherpetic neuralgia (PHN) results from reactivation of varicella-zoster virus. Pain increases sharply with advancing age and the elderly are more inclined to suffer. If herpes zoster is not treated early, patients may develop PHN. For some, it can persist for 1–2 years. Botulinum toxin injection (BTX-A) has been useful for patients suffering from PHN pain. Objective: The objective of this study was to study the effect of botulinum toxin on pain severity and quality of life in patients with PHN. Methods: A hospital record-based follow-up study was carried out among 30 PHN patients treated with hypodermic injection of BTX-A. Before injection, we measured Visual Analog Score (VAS) for pain severity and the Quality of Life (QOL) Scale using short form survey-36 (SF-36) score. BTX-A injections were given, and patients were followed every month for 6 months. During follow-up, VAS, QOL, pain frequency, and analgesic use were measured. Results: Majority were 60–69 years (40%). The proportion of males and females was not much different. Mean pain severity reduced significantly from 8.9 to 5.8 at 6 months. QOL improved significantly in 6 months. Pain frequency decreased significantly from 22.33 to 18.56 at 6 months. Mean analgesics use was 87.43 which reduced significantly to 7 at 2 weeks after BTX-A and then slowly increased to 7.66 at 4 weeks, to 8.23 at 12 weeks, and 10.4 at 24 weeks. Conclusion: Using BTX-A for treating PNH is promising and gives long-lasting results. It can be considered a valid approach in the treatment of PNH, especially in nonresponsive patients.

Bladder Wall Structure Alterations in Patients Treated With Botulinum Toxin for Detrusor Overactivity - A Morphological Study.

The overactive bladder syndrome (OAB) is a bothersome condition that affects up to 33% of the population. In up to 69% of the cases, the underlying condition is an overactive detrusor (DO). Treatment options rely on behavioral changes, medical treatment, neuromodulation, and invasive treatment, such as injecting botulinum toxin (BoNT) in the detrusor or augmentation cystoplasty. The aim of this study was to evaluate, by morphological assessment on cold-cup biopsies of the bladder, the effect of botulinum toxin injections on the bladder wall, focusing on the histological structure and signs of inflammation and fibrosis. We evaluated consecutive patients with DO that received BoNT intradetrusor injections. We analyzed inflammation and fibrosis in 36 patients, divided into two groups based on their history of BoNT treatment. Our patients underwent at least one round of injections and specimens were compared individually, before and after each injection. A decrease in inflammation was found in 26.3% of the cases, a reactive increase in 31.5%, and no change in 42.1%. No de novo or increase in preexisting fibrosis was found. In some cases, fibrosis diminished after a second round of BoNT. In most cases, BoNT intradetrusor injections in DO patients showed no effect on bladder wall inflammation and actually improved the inflammatory condition of the muscle in a significant number of samples.

Evaluation of the effectiveness of botulinum toxin injection on reducing phantom pain in patients

ObjectivePhantom pain is very common in amputations and is associated with severe pain followed by distress and poor quality of life. The aim of this study is to evaluate the effectiveness of botulinum toxin injection in reducing phantom pain in patients referred to Imam Hossein Hospital. Materials and methodsIn this double-blinded placebo study, 30 patients with phantom pain referred to Imam Hossein Hospital were included. The participants were divided into two groups of 15 intervention and placebo. In the intervention group, botulinum toxin A was injected to reduce pain in patients and normal saline was injected in placebo group. Patients' pain relief was assessed at 0, 2, 4, 8, and 16 weeks of the treatment. Data were analyzed using SPSS 23 software. ResultsBotulinum toxin A injection significantly reduced phantom pain in intervention group at 0, 2, 4, 8, and 16 weeks of the treatment p < 0.05. This reduction was also seen in regard to the cause of amputation, such as war, accidents, and unknown causes. ConclusionThe use of botulinum toxin A seems to be effective in reducing pain in patients with phantom pain. Comparative studies and comparisons of the effect of botulinum toxin with common treatments are recommended.

The Use of Botulinum Toxin Injection For Post-Radiation Breast Cancer Survivors With Shoulder Pain

<h3>Research Objectives</h3> To evaluate the effectiveness of botulinum toxin injections for post-radiation breast cancer survivors with shoulder pain by physiatry. A secondary objective was to determine other physiatry interventions ordered. <h3>Design</h3> Retrospective Review. <h3>Setting</h3> National Cancer Institute Comprehensive Cancer Center. <h3>Participants</h3> 47 patients were referred by breast radiation oncology to PM&R from 1/1/2018-12/31/2021. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Physiatric (PM&R) interventions utilized. <h3>Results</h3> 2 out of 49 total patients referred to PM&R by breast radiation oncology were for reasons other than shoulder pain/dysfunction. After PM&R evaluation, 28/47 shoulder pain/dysfunction patients evaluated had botulinum toxin recommended, however, only 18/28 received the botulinum toxin injection. Out of the 10 patients who did not receive botulinum toxin injection, 2/10 preferred to get botulinum toxin by a physiatrist/neurologist closer to home, 1/10 decided on a trigger point injection instead, and 7/10 were lost to follow-up. 17/18 patients who received botulinum toxin injection voiced improvement in pain after injection. 24/28, 16/18, and 2/10 patients who had toxin injection recommended, toxin injection received, and toxin injection not recommended respectively, had spasms, cramping or Charley horses mentioned in their PM&R evaluations. <h3>Conclusions</h3> 17/18 patients reported improvement in pain with botulinum toxin injection. Most patients complained of muscle spasms before toxin injection was recommended. Additional research on the effectiveness of botulinum toxin injection in post-radiation breast cancer survivors with muscle spasm related pain is needed. <h3>Author(s) Disclosures</h3> N/A.

Efficacy of botulinum toxin injection versus bilateral medial rectus recession for comitant esotropia: a meta-analysis.

To compare the effectiveness of botulinum toxin injection (BTX) and bilateral medial rectus recession (BMR) in the treatment of comitant esotropia. An exhaustive search of the literature from Pubmed, EMBASE, Web of Science, and Cochrane Library databases was carried out until April 2022. No language restrictions were applied. The literature was rigorously screened against eligibility criteria. Odds ratios (ORs) and 95% confidence interval (CI) were calculated. A total of 9 articles with 1100 participants were included in this meta-analysis. Three studies compared the effects of BTX to BMR on infantile esotropia, five studies compared the effects of BTX to BMR on acute acquired comitant esotropia, and one study compared the therapeutic effects between BTX and BMR for partially accommodative esotropia. Our pooled results showed that BMR achieved higher overall success rate compared with BTX (OR, 0.49; 95%CI, 0.37-0.64; P < 0.001) and patients subjected to the BTX procedure had higher overall rate of undercorrection (OR, 2.27; 95%CI,1.71-3.02; P < 0.001). No statistical difference in the overall overcorrection rate was observed between the two groups (OR = 0.42, 95% CI: 0.17 ~ 1.03, P = 0.06). Further analysis found that BMR was more effective for infantile esotropia compared to botulinum toxin injections (OR, 0.40; 95%CI, 0.27-0.57; P < 0.001). Nevertheless, the same effect was observed for BMR and BTX in the treatment of acute acquired comitant esotropia (OR, 0.97; 95%CI, 0.50-1.87; P = 0.93). The present meta-analysis indicated that the BMR procedure achieved a higher success rate and a lower undercorrection rate in patients with comitant esotropia. However, BTX demonstrated similar treatment effects to BMR surgery in the treatment of acute acquired comitant esotropia.

A computed tomography study investigating the effects of botulinum toxin injections prior to complex abdominal wall reconstruction

ObjectiveTo explore how intramuscular injection of botulinum toxin A (BTA) affects the lateral abdominal wall (LAW) musculature, abdominal- and hernia dimensions, and muscle structure on computed tomography (CT) in patients scheduled for complex abdominal wall reconstruction (CAWR).MethodsRetrospective analysis of prospectively registered patients who received bilateral intramuscular BTA injections into all three muscles of the LAW. Only patients for which a CT was available before and 3–6 weeks after BTA treatment prior to surgery were analyzed.ResultsFifty-two patients were analyzed. Median hernia width in all patients decreased with 0.4 cm (IQR − 2.1;0.6) (p = 0.023). Median intra-abdominal transverse diameter increased with 0.9 cm (IQR − 0.2;3.3) (p = 0.001) and the intra-abdominal anterior–posterior diameter decreased with 0.5 cm (IQR − 1.3;0.5) (p = 0.017), making the abdomen more oval. Median LAW muscle length increased with 0.9 cm (IQR 0.0;2.4) per side (p < 0.001), muscle thickness decreased with 0.5 cm (IQR − 0.8;− 0.2) (− 25.0%) per side (p < 0.001), and muscle mass decreased with 3.9 cm2 (IQR − 6.4;-1.5) (− 15.8%) per side (p < 0.001). Median HU of the psoas muscles (density) increased with 4.8 HU (IQR 0.4;9.7) (10.3%) per side (p < 0.001). Effects of BTA were more pronounced in patients with a loss of domain (LoD) ≥ 20%.ConclusionsThe main effect of BTA injections is elongation and thinning of the LAW muscles, more than a decrease in hernia width. Concomitantly, the abdomen becomes more oval. An increase of psoas muscles density is seen, associated with offloading of the LAW muscles. Patients with large LoD have a proportionally higher effect of BTA.