Predictability in Lip Repositioning with Botulinum Toxin for Gummy Smile Treatment: A 3-Year Follow-up Case Series

2020 ◽  
Vol 40 (5) ◽  
pp. 703-709
Author(s):  
Andrea Vergara-Buenaventura ◽  
Frank Mayta-Tovalino ◽  
Albert Correa ◽  
Erin Breen ◽  
Gerardo Mendoza-Azpur
Keyword(s):  
Botulinum Toxin ◽  
Case Series ◽  
Gummy Smile

Selective lateral laser thyroarytenoid myotomy for adductor spasmodic dysphonia

2010 ◽  
Vol 124 (8) ◽  
pp. 886-891 ◽  
Author(s):  
A Hussain ◽  
M Shakeel
Keyword(s):  
Botulinum Toxin ◽  
Minimally Invasive ◽  
Clinical Assessment ◽  
Clinical Case ◽  
Case Series ◽  
Spasmodic Dysphonia ◽  
Adductor Spasmodic Dysphonia ◽  
Glasgow Benefit Inventory ◽  
Botulinum Toxin Therapy

AbstractObjective:Selective lateral laser thyroarytenoid myotomy is a conceptually sound, simple, minimally invasive, repeatable and predictable new surgical procedure for treating adductor spasmodic dysphonia. This paper aims to introduce and describe the surgical technique, and to present a clinical case series and its outcomes.Study design:A prospective, clinical case series treated with selective lateral laser thyroarytenoid myotomy, with follow up of 2.5 years.Method:Pre- and post-operative data were collected prospectively for patients undergoing selective lateral laser thyroarytenoid myotomy. These data included patient demographics, previous interventions for adductor spasmodic dysphonia, technical aspects of surgery and clinical outcome. Outcome data included clinical assessment, voice handicap index, need for further intervention, and patient satisfaction assessed by subjective improvement (detailed subjectively by the patients themselves and objectively using the Glasgow benefit inventory).Results:Four patients (two men and two women; mean age 65 years; age range 41–80 years) were included. The mean duration of adductor spasmodic dysphonia was 11 years. All patients had previously been treated with botulinum toxin A. All patients reported improvement in voice quality, fluency, sustainability and elimination of voice breaks over 2.5 years' follow up. Clinical assessment revealed no alteration in mucosal wave, and complete relief of hyperadduction was observed on phonation. No patients required supplementary botulinum toxin treatment during follow up.Conclusion:Selective lateral laser thyroarytenoid myotomy seems to represent a curative procedure for adductor spasmodic dysphonia, a chronic, debilitating condition. This procedure is conceptually simple, minimally invasive and repeatable. It also seems to offer a safe and lasting alternative to botulinum toxin therapy.

scholarly journals Smile — one of the important elements of face aesthetics

2019 ◽  
Vol 2 (2) ◽  
pp. 101-110
Author(s):  
Patrycja Przybylska ◽  
Tomasz Siniecki ◽  
Teresa Matthews‑Brzozowska
Keyword(s):  
Botulinum Toxin ◽  
Maximum Effect ◽  
Upper Lip ◽  
First Case ◽  
Patient Reported ◽  
Levator Labii Superioris ◽  
The Face ◽  
Gummy Smile

The harmony of the smile depends not only on the dentition, but also on the gum tissue, which excessively exposed can negatively affect aesthetics of the smile. Exposure of a small amount of gum during a smile is acceptable however a smile in which the exposure of the gum is more than 2 mm is considered an aesthetic defect called gummy smile. Among the causes of gingival smile listed are: shortened or hyperactive upper lip muscles (levator labii superioris, levator labii superioris alaeque nasi, zygomatic minor muscles), vertical maxillary excess, extrusion of alveolar ridges, altered passive eruption. In the case of hyperactive upper lip muscles, botulinum toxin can be used — this procedure was used in the described cases, and the effects were assessed using the FotoMedicus system and measurements of gingival exposure. In first case Bocouture botulinum toxin was administered on both sides, 4 units bilaterally in the levator labii superioris muscle and 2 units into levator anguli oris muscle. In total, 12 units were given. During the follow‑up the patient reported the start of the effect from the 5th day after the supply with the maximum effect after 12 days. A 6 mm correction of gummy smile was achieved. In the second case 4 units of botulinum toxin were applicated bilaterally into levator labii superioris alaeque nasi muscle. A 3 mm correction of gummy smile was achieved. The aesthetics of the face in a smile definitely improved in both men.

scholarly journals P128 BOTULINUM TOXIN A IN CONJUNCTION WITH NEGATIVE PRESSURE WOUND THERAPY AND MESH-MEDIATED FASCIAL TRACTION PROVIDES HIGH RATE OF FASCIAL CLOSURE IN PATIENTS WITH OPEN ABDOMEN

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Irene Schmidt ◽  
Hans Friis Andersen ◽  
Nellie Zinther
Keyword(s):  
Botulinum Toxin ◽  
Open Abdomen ◽  
Botulinum Toxin A ◽  
Case Series ◽  
High Rate ◽  
Fascial Closure ◽  
Toxin A ◽  
Fascial Defect ◽  
The Mean

Abstract Aim Presentation of our data on Vacuum-Assisted Wound Closure and Permanent Onlay Mesh-Mediated Fascial Traction (VAWCPOM) in combination with Botulinum Toxin A (BTX-A) injection in the lateral abdominal wall as a treatment of the open abdomen (OA). Material and Methods This is a retrospective case series including patients treated for OA from January 2017 till March 2021 with VAWCPOM and BTX-A. Patient records were collected from medical charts, incl. age, sex, body mass index (BMI), comorbidity, initial fascial defect size, time until fascial closure, complications and, when available, outpatient follow-up. Results A total of 33 patients with OA were included. The mean age was 62,5 years, male/female ratio was 15:18, with a mean BMI of 35,4 kg/m2. The mean width of the fascial defect was 13,5 cm (5 - 25cm). The rate of fascial closure was 96,9%, achieved within a mean of 22,7 days. Fascial closure was not attainable in one patient who developed enterocutaneous fistula under treatment. 22 patients experienced in-hospital complications. Short-term follow-up was conducted in 22 patients, with hernia recurrences in three. Conclusions Treatment of OA remains a surgical challenge. This case series shows promising results with a high rate of fascial closure using a combination of VAWCPOM and BTX-A and an acceptable rate of postoperative complications in this severely challenging patient group. The rate of primary closure indicates that this may be the future management of open abdomen.

Ten-Year Follow-Up in a Case Series of Integrative Botulinum Toxin Intervention in Adolescents with Chronic Daily Headache and Associated Muscle Pain

2012 ◽  
Vol 43 (06) ◽  
pp. 339-345 ◽  
Author(s):  
A. Schroeder ◽  
K. Huss ◽  
A. Blaschek ◽  
I. Koerte ◽  
B. Zeycan ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Chronic Daily Headache ◽  
Muscle Pain ◽  
Case Series ◽  
Daily Headache

scholarly journals Abelchia: inability to belch/burp—a new disorder? Retrograde cricopharyngeal dysfunction (RCPD)

2021 ◽  
Author(s):  
Yakubu Karagama
Keyword(s):  
Botulinum Toxin ◽  
General Anaesthesia ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Injection ◽  
Case Series ◽  
High Dose ◽  
Toxin A ◽  
Radiological Investigation ◽  
Retrosternal Pain

Abstract Case series This is retrospective case series involving 72 patients who presented with symptoms associated with inability to burp. The following symptoms was described by almost all the patients; retrosternal pain after eating or drinking, bloating feeling in the stomach, gurgling noise in the throat, excessive flatulence. These symptoms are worse with fizzy/carbonated drinks and beer. A full clinical history and examination plus endoscopic and in some cases barium a swallow radiological investigation was done. Procedure The surgery was performed under a general anaesthesia for all cases. Suspension pharyngoscopy in supine position using a Weerda diverticuloscope to identify the cricopharyngeal bar muscle. High dose of botulinum toxin A (botox) 100 iu was injected into the cricopharynxgeus muscle under a general anaesthesia. Results A total of 72 patients were diagnosed and undergone surgery between November 2016 and December 2020. There were 50 male and 22 female patients. Their average age was 30 (range 18–68 years old). All patients were able to burp again within first 4 weeks of the injection. This persisted even after the Botox worn off beyond the 3 months in 96% of cases. The average follow-up was 24 months post injection with longest follow-up 48 months (range 1–48 months). Conclusion The author reported a new condition of inability to burp due to failure of the cricopharyngeal sphincter to relax spontaneously and outcome of treatment using botulinum toxin A injection into the cricopharyngeus muscle. It is expected that the paralysing action of botulinum toxin injection last approximately 3 months. However, this group of patients seem to be cured even after the effect of the botox is worn off. The author therefore postulated that there might me some neural dysfunction that inhibits the brain to send signals to the cricopharyngeal sphincter to initiate burping. Once burping is re-established with the help of botox injection, spontaneous burping seems to occur and sustained even after the botox is worn off.

scholarly journals Lip repositioning, a solution for gummy smile

2021 ◽  
Author(s):  
Pardis Haddadi ◽  
Hadi Zare ◽  
Ali Azadikhah
Keyword(s):  
Successful Treatment ◽  
Surgical Approach ◽  
Treatment Modality ◽  
Case Series ◽  
Current Case ◽  
Gummy Smile

For many years oral esthetic problems treated by dentists were limited to those involving the teeth without giving consideration to the gingiva. However, today it is well established that these structures should be in balance to appear esthetically pleasing. More than 3mm gingival show during smiling is considered as ‘excessive gingival display’ also known as “gummy smile”, which is not attractive. The current case series, presents three patients with gummy smile managed by lip repositioning surgery, each with 1 year follow up. Our objective was to introduce lip repositioning as a successful treatment modality to decrease gingival show using a simple and conservative surgical approach.

Botulinum Toxin A in the Management of a Gummy Smile: A Clinical Controlled Preliminary Study

2021 ◽  
Author(s):  
Aline Bitencourt Costa ◽  
Dinete Romansina ◽  
Juliana Ramalho ◽  
Priscilla Pereira ◽  
Tamara Kerber Tedesco ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Botulinum Toxin ◽  
Muscle Activity ◽  
Botulinum Toxin A ◽  
Toxin A ◽  
Significant Difference ◽  
Satisfaction With Treatment ◽  
Group 2 ◽  
Gummy Smile

Abstract Background Botulinum toxin-A (BTX-A) is recent technique to treat gummy smile. Objectives This randomized controlled preliminary clinical trial evaluated BTX-A on excessive gingiva display (EGD) reduction, muscle activity, and patient satisfaction at 2, 8, 12, 16, 21, and 25 weeks. Methods Group 1(G1): 4 points of BTX-A application (2U/point) for relaxation of the levatorlabii superioris alaeque nasi (LLSAN) and levatorlabiisuperioris (LLS) muscles; Group 2(G2): Two points of BTX-A (2U/point) for relaxation of the LLSAN muscle. Results A high dropout of patients during some follow-up sessions occurred. So, considering this data limitation, the results found were considered a preliminary outcome. In 2 weeks, there was a significant difference between baseline regarding the reduction of EGD in G1 and G2, reduction in muscle activity in G1, and increased satisfaction in G1 and G2. In 2 weeks, there was no difference between both groups. Statistical EGD reduction was maintained until 16 weeks for G2 and 25 weeks in G1. After 14 days there was a gradual recovery of muscle activity in both groups until baseline values recovery within 25 weeks. Patients' satisfaction with treatment lasted 21 weeks in G1 and 16 weeks in G2. Conclusions Increasing BTX-A injection points resulted in a prolonged effect regarding EGD reduction and patient satisfaction but did not increase the intensity of the outcome. However, due to the high dropout of patients, this is a suggested preliminary conclusion based on available data and more additional studies are necessary to testify the results described.

scholarly journals Efficacy and Safety of Electromyography-Guided Injection of Botulinum Toxin to Treat Retrograde Cricopharyngeus Dysfunction

OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2198958
Author(s):  
Benjamin Wajsberg ◽  
Rebecca C. Hoesli ◽  
Melissa L. Wingo ◽  
Robert W. Bastian
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Injection ◽  
Tertiary Care ◽  
Case Series ◽  
Efficacy And Safety ◽  
Retrospective Case ◽  
Office Setting ◽  
Cricopharyngeus Muscle ◽  
Associated Symptoms

Objective To report the efficacy and safety of electromyography-guided percutaneous botulinum toxin injection into the cricopharyngeus muscle in an office setting for treatment of the inability to belch and associated symptoms caused by retrograde cricopharyngeus dysfunction (R-CPD). Study Design Retrospective case series of treated patients. Setting Tertiary care laryngology clinic. Methods A retrospective review was performed on 18 consecutive patients who were diagnosed syndromically with R-CPD. The combined diagnostic test and treatment—specifically, botulinum toxin injection into the cricopharyngeus muscle—was accomplished in an office setting by a single surgeon using electromyography guidance. Items assessed are efficacy, safety, complications, and duration of benefit. Results All 18 patients (100%) treated in the in-office setting gained the ability to burp with improvement in the associated symptoms of R-CPD at initial follow-up. Of those who had the in-office procedure performed initially, 80% maintained the ability to burp at 6 months with relief of all the associated symptoms of R-CPD. No patients experienced permanent complications from the injection, but 7 patients experienced varying degrees of noisy breathing within 1 week after the procedure, which was managed with breathing techniques and resolved. Conclusion In a case series of 18 patients with R-CPD, all patients gained the ability to burp with improvement in the majority of their symptoms of R-CPD at the time of their initial follow-up at 1 week. None experienced severe complications, and 7 experienced transient noisy breathing, which resolved.

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