B超引导下A型肉毒毒素注射治疗咬肌肥大的效果

Effects of botulinum toxin A injection therapy with ultrasound-guided for benign masseter hypertrophy

目的评估超声引导下A型肉毒毒素注射治疗咬肌肥大的效果。方法 2019年3月至2020年4月, 空军军医大学第二附属医院烧伤整形科对20例咬肌肥大患者进行A型肉毒毒素注射, 其中试验组10例, 术前超声测量咬肌厚度, 且术中超声引导下精确注射, 术后超声复查测量咬肌厚度;对照组10例, 用传统的3点注射方法, 术后超声复查测量咬肌厚度。结果注射后分别于4、12、24、36周进行超声检查, 评估测量咬肌厚度, 两组咬肌厚度均较治疗前缩小(P<0.001), 注射后4~12周咬肌厚度缩小最明显, 注射后4周, 平均缩小26.8%, 注射后12周平均缩小28.4%。24周咬肌厚度有所恢复, 比治疗前缩小22%, 36周比治疗前缩小20%。随访(8.0±2.4)个月, 无严重并发症, 对照组1例出现咬肌局部隆起, 考虑可能是药物分散不均匀所致。试验组10例患者均满意, 对照组7例患者满意。结论超声引导下, A型肉毒毒素注射可有效治疗咬肌肥大, 比传统注射方法更精确有效。

Objective To evaluate the efficacy of botulinum toxin A injection therapy with ultrasound-guided for benign masseter hypertrophy.Methods Twenty cases(40 sides)of masseter hypertrophy were injected with botulinum toxin A,among which 10 cases were taken as experimental group and the other 10 cases as control group.The experimental group had preoperative ultrasound examination to measure the thickness of masseter,and use ultrasound-guided precise injection during the operation,and then ultrasound recheck to measure the postoperative masseter thickness;The other 10 cases of control group adopt traditional 3-point injection method.Results The masseter thickness of the two groups at different period of times after treatment was decreased(P<0.001),the most obviously decrease happened 4-12 weeks after injection.The mean reduction was 26.8%at 4 weeks and 28.4%at 12 weeks after injection.Masseter muscle thickness recovered by 22%at 24 weeks and by 20%at 36 weeks.The average follow-up was 6.0±2.4 months with no serious complications occurred.In the control group,there was a partial masseter bulge in one case.The satisfactory rate of the patients in the experimental group was higher than that of the control group.Conclusions Botulinum toxin A injection therapy with ultrasound-guided for benign masseter hypertrophy is an effective treatment,which is more accurate and effective than the traditional injection method.