A型肉毒毒素矫正面神经麻痹患者口角歪斜的临床研究

目的：通过健侧面肌注射A型肉毒毒素来矫正患者存在或遗留的口角歪斜和鼻唇沟不对称，满足爱美患者的要求.方法：将近几年来在门诊就诊和收治的一部分面瘫患者依据一定标准纳入治疗观察对象，除对照组外将他（她）们随机分为若干治疗组：升降（口角肌）组（含降口角肌、提口角肌、颧大肌和颧小肌）、笑肌组和联合组，除对照组外各组在健侧面肌相应肌肉注射A型肉毒毒素5U，2周后观测每个患者双侧口角到门齿中缝的距离差.结果：各治疗组的口角歪斜均得到一定的纠正，其中升降组的效果小一些，但鼻唇沟不对称明显得到改善;笑肌组效果较明显，但表情动作受到的影响较大;联合组效果最明显，鼻唇沟变得对称而表情动作受到的影响大.结论：健侧面肌注射一定剂量的A型肉毒毒素可以矫正周围性面瘫患者的口角歪斜和不对称的鼻唇沟。

Botulinum toxin type a corrects the deflection of angle of mouth of patients with facial palsy

Objective By injecting botulinum toxin type A(BTX-A) into the healthy facial muscles being responsible for the deflection of angle of mouth and asymmetric nasolabial channel of patients with peripheral facial palsy to satisfy the patients who were fond of beauty.Methods According as a special standard,the patients including the inpatients and the outpatients with peripheral facial palsy were divided into contrast group and a certain number of treated groups: levator-depressor group(including depressor muscle,levator muscle,greator zygomatic muscle and smaller zygomatic muscle),risorius muscle group and combined group(including the above-mentioned muscles).Except for the contrast group,all treated groups were injected BTX-A 5U in different muscles in the healthy face.After two weeks,the distances from the healthy angle of mouth to the midline of the teeth and from the sick angle of mouth to the midline of the teeth were measured.The difference of the distances was calculated and was contrasted to the previous before being treated.Results The deflection of angle of mouth in all the treated groups was corrected in dissimilar degree.The effect in the levator-depressor group was smaller but the asymmetric nasolabial channel was amellorated obviously.The effect in the risorius muscle group was bigger but the expressional action reduced.The effect in the combined group was biggest but the expressional action also reduced.Conclusion A certain dosage of BTX-A being injected into the healthy facial muscles could correct the the deflection of angle of mouth and asymmetric nasolabial channel of patients with peripheral facial paralysis.