PRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 10 October 2006
Effects of Botulinum Toxin Type A Therapy for
Synkinesis after Peripheral Facial Palsy
Hiroo Inamura, Hidehiro Koshu, Kazuhiro Kawaguchi,
Yasuhiro Abe and Masaru Aoyagi
(Yamagata University School of Medicine)
Once synkinesis and facial contracture after facial nerve palsy have developed, spontaneous recovery is unpredictable and many patients suffer from unpleasant symptoms for a long time. This paper examined the results of treating facial synkinesis and contracture using botulinum toxin type A (BTX). Eleven patients with synkinesis or facial contracture were treated with BTX, and the effects of this treatment were compared with patients with blephalospasm (BS) and hemifacial spasm (HFS) by assessing the degree of satisfaction, therapeutic interval, and dose of BTX. Therapeutic effects were also evaluated by recording the width of the affected eyelid and investigation of the facial score using the Sunnybrook grading system before and after treatment.
Compared to the BS and HFS patients, the patients' satisfaction levels were higher, therapeutic intervals were longer, and the doses of BTX were lower. In all patients, the width of the affected eyelid increased significantly and the Sunnybrook facial score improved after treatment. The degree of satisfaction tended to be higher in patients treated at an earlier date than in those treated at over 60 months. No severe side effects were observed. These findings suggest that BTX injection is useful and safe for the treatment of facial synkinesis and contracture.
Key words : botulinum toxin, synkinesis, facial palsy, contracture