三维扫描评估A型肉毒毒素治疗咬肌肥大继发的颧下区软组织厚度变化

Quantitative evaluation of subzygomatic depressions secondary to masseter hypertrophy with botulinum toxin A injection using 3D scanning technology

目的 评估A型肉毒毒素(botulinum toxin type A, BTX-A)注射治疗单纵向咬肌肥大后,咬肌区及颧下区软组织厚度变化。方法 自2019年7月至2021年12月,哈尔滨医科大学附属第一医院整形美容中心以BTX-A注射治疗单纵向咬肌肥大患者91例,并采用3D扫描仪采集术前、术后2个月及6个月的3D影像学资料,并对比咬肌区及颧下区的线距与面距,以分析其软组织厚度变化。结果 91例(182侧)患者获随访6个月。术后2个月,AA1(n=91)、DF(n=182)、DG(n=182)长度均较术前明显减少(P<0.05),但术后6个月时与术前相比,差异无统计学意义(P>0.05)。治疗后2个月,175侧(96.2%)出现咬肌区软组织厚度减少,174侧(95.6%)出现颧下区软组织厚度减少;治疗后6个月,61侧(33.5%)出现咬肌区软组织厚度减少,81侧(44.5%)出现颧下区软组织厚度减少。结论 BTX-A注射治疗单纵向咬肌肥大疗效显著,但可能会导致患者出现颧下区凹陷。

Objective To measure the changes in soft tissue thickness in the masseter and sub-zygomatic regions induced by botulinum toxin type A(BTX-A)injections for single longitudinal masseter hypertrophy using a 3-dimensional(3D)scanning technology.Methods From July 2019 to December 2021,3D imaging data of 91 patients who received BTX-A injection with single longitudinal masseter hypertrophy were retrospectively analysed.Changes of the soft tissue thickness in the subzygomatic area and masseter area,assessed by Artec EVA 3D scanner preoperatively,2-month,and 6-month postoperatively were quantitatively analysed and expressed by linear and surface distance.Results Overall,91 patients(182 cases)were followed-up for 6 months.At 2 months postoperatively,the length of AA1(n=91),DF(n=182),and DG(n=182)were significantly reduced compared with the preoperative period(P<0.05),with no statistical difference between the preoperative and 6-month postoperative values(P>0.05).Totally 175 cases(96.2%)and 174 cases(95.6%)showed a decrease of the thickness of the soft tissue in the masseter and subzygomatic areas at 2 months after injection respectively.Besides,61 cases(33.5%)and 81 cases(44.5%)maintained the depression in the masseter and subzygomatic areas at 6 months after injection respectively.Conclusion BTX-A injection could induce depression in subzygomatic area to different extents during treatment of a single longitudinal masseter hypertrophy.