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.

IF 2 3区医学 Q2 SURGERY Aesthetic Plastic Surgery Pub Date : 2024-12-12 DOI:10.1007/s00266-024-04589-8

Franco Patriani D'Andrea, Cristina Alessi, Cristiane Cárcano, Vanessa Tanaka, Bruno Alvares, Davi Brito, Isabela Alves Guerra, Ricardo Gama, Marcelo Riberto

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Abstract

Background: 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.

Aim: To assess the effectiveness of combined BTA and HA intervention in PFP patients, comparing it to conventional treatment (physiotherapy).

Method: 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.

Results: 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.

Conclusion: 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.

Level of evidence ii: 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 .

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肉毒毒素与透明质酸联合治疗肿瘤性慢性周围性面瘫与保守干预的疗效比较。

背景：头颈部肿瘤常导致周围性面瘫（PFP），影响面部表情并引起心理困扰。标准的治疗方法包括物理治疗，但A型肉毒杆菌毒素（BTA）和透明质酸（HA）注射在促进面部对称方面显示出希望。目的：评价BTA与HA联合干预治疗PFP患者的疗效，并与常规治疗（物理治疗）进行比较。方法：18例患者在巴雷托斯医院进行单盲随机临床试验，对照组接受标准治疗，CT组接受BTA和HA联合治疗。评估采用Sunnybrook面部分级量表（SFGS）和心理社会面部不对称量表（EPAF）问卷调查，以及照片分析。结果：与对照组相比，CT显着改善了面部对称性和心理社会方面。SFGS CT评分提高了27分，对照组提高了3分；EPAF CT评分降低了16分，对照组提高了1分。照片分析显示，CT患者的动态微笑有所改善。在30天内，功能改善更为明显，并在4个月内持续改善。在整个研究过程中，心理社会得分不断上升。只有两名CT患者报告了短暂的饮酒和咀嚼问题。结论：该研究提示了联合治疗在心理社会和功能方面的积极影响，强调需要进一步强有力的研究来确定其治疗潜力。证据等级ii：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明www.springer.com/00266。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Aesthetic Plastic Surgery 医学-外科

CiteScore

4.40

自引率

25.00%

发文量

479

审稿时长

3 months

期刊介绍： Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP). Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships. Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.