Botulinum toxin for radiation-induced facial pain and trismus
Received 31 August 2007; received in revised form 11 December 2007; accepted 18 December 2007.
Objective
To report the efficacy of botulinum toxin A for radiation-induced pain, trismus, and masticator spasm in head and neck cancer.
Patients and Methods
This prospective nonrandomized study included patients in complete remission with radiation-induced pain and trismus with or without masticator spasms. Fifty units of Botox (Allergan) or 250 units of Dysport (Ipsen) were injected transcutaneously into the masseter muscles. Jaw opening was measured and patients answered 20 questions about jaw opening, pain, and cramps, before injection at 1 month.
Results
Nineteen patients (7 women, 12 men) were included. Median time after radiation therapy was 5 years (range, 11 months to 22 years). At 1 month, no significant increase in jaw opening was recorded. Improvement was noted in the functional domain (P = 0.004), for pain (P = 0.002) and cramps (P = 0.004), but not in the social (P = 0.83) or emotional (P = 0.43) domains. No side effects occurred.
Conclusions
Botulinum toxin did not improve trismus but significantly improved pain scores and masticator spasms (oromandibular dystonia).
aDepartment of Otolaryngology–Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
bDepartment of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
cDepartment of Otolaryngology, Fondation Ophtalmologique Adolphe de Rothschild, Villejuif, France.
Corresponding author: Dana M Hartl, MD, PhD, Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, 39, rue Camille Desmoulins, 94805 Villejuif Cedex, France.
ABSTRACT