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Botulinum Toxin A for Treatment of Masseteric Muscle Hypertrophy: Long-term Follow-up

Author: PanShengSheng
Tutor: LiHua
School: Zhejiang University
Course: Plastic Surgery
Keywords: botulinum toxin masseteric muscle hypertrophy
CLC: R622
Type: Master's thesis
Year: 2011
Downloads: 18
Quote: 0
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Abstract


Objective:To study the safety and efficacy of botulinum toxin A in the treatment of masseteric muscle hypertrophy.Methods:Twenty-two patients(42 sides)were treated by intramuscular injection of botulinum toxin A:30-50U for each side of 20 patients with bilateral masseteric hypertrophy; 60U for 1 male patient with unilateral hypertrophy; 30U for 1 female patient with unilateral hypertrophy.We use the electromyographic measurement to observe the changes in masseter contraction,the effect and complications were recorded at different time.Results:The masseteric contraction(evaluated by EMG RMS)at different time post injection was reduced significantly(p<0.001).Maximum reduction was recorded at 4 weeks after injection.The follow-up period was 6-20 months.3 patients(13.6%) were not satisfied with the result:2 patients found no change in masseter thickness;one found the left masseter comes out to be larger than the right in sixth month.5 patients(22.7%) were very satisfied with the effect,14 patients(63.6%) were satisfied with the effect.2 patients(9.1%) begin to see the effect 15 days after the injection; 17 patients(77.3%) found it 1 month after the injection and 1 patient(4.5%) found it 2 months after the injection.7 patients(31.8%) got the obvious effect 1 month after the injection;6 patients(27.3%) got the obvious effect 2 months after the injection;another 6 patients(27.3%)got it 3 months after the injection; 1 patient(4.5%) got it 5 months after the injection.2 patients(9.1%) begin to lose effectiveness 5 months after the injection;and 1 patient(4.5%) in sixth month,4 patients(18.2%) in seventh month,5 patients(22.7%) in eighth month,6 patients(27.3%) in ninth month;other 2 patients(9.1%) still keep the effect well after 6 months. No long-term severe complications appeared. Mild complications include: patient with local swelling and mild pain;3 patients with dysmasesia and one with nausea, which all disappear in a month.Conclusion:Botulinum toxin type A injection is a safe and effective treatment for masseteric hypertrophy. The patients’satisfaction is high (86.3%), there is only a few mild adverse effects and complications, maybe the best treatment for masseteric hypertrophy now.But there is a high probability of recurrence after the initial injection.The effect is going to maintain about 8-12 months, after that the patient will need another injection.

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