A型肉毒毒素在额部软组织扩张中的应用

目的：探讨A型肉毒毒素辅助额部软组织扩张的作用效果。方法：在置入150ml扩张器前，左右平分额部扩张器置入区，于一侧额肌内注射A型肉毒毒素，对侧注射生理盐水作为对照，采用双盲法测定扩张器注水量及注水时间，并对比两侧注水时的疼痛程度，观察临床效果。结果：5例扩张器均给予超量注水，平均注水量216ml，平均注水时间7周。5例均于扩张器注水过程中在对照侧出现局部疼痛不适，注射A型肉毒毒素侧未感到疼痛，并且肿胀感明显低于对照侧。扩张皮瓣转移修复时见注射A型肉毒毒素侧额肌厚度明显小于对照侧，皮瓣较薄，转移后形态较好，术后皮瓣均完全成活，无坏死。结论：在额部软组织扩张时，应用A型肉毒毒素注射于额肌，使额肌松弛，可使额部扩张阻力减小，扩张时间缩短，减轻扩张时的局部疼痛及肿胀感，使皮瓣更薄，有利于获得更好的修复效果。

Botulinum toxin A in forehead soft tissue expansion

Objective Using botulinum toxin A in forehead soft tissue expansion to assist the soft tissue expansion. Methods Before implanting the 150ml expander, Botulinum toxin A was injected in forehead muscle of one side, saline in another side. While inflating the expander, the injection volume, expansion time and pain were observed in doubleblind. Results All the expanders of five patients were in over-inflation. The average injection volume is 216ml. The expansion time is 7 weeks. While inflating the expander, there was obvious pain in control side, but not in botulinum toxin A side, The botulinum toxin A make the expanded forehead flap thinner than the control side. The results were good and there was no complication. Conclusion Before implanting the expander in forehead, The botulinum toxin A is injected into the forehead muscle to make it relax, which could reduce the expansion resistance, shorten the expansion time, release the pain, as well as make the expanded forehead flap thinner.