얼굴신경마비 후 얼굴연축 환자에서 보툴리눔 독소를 이용한 치료
Botulinum Toxin A Treatment for Patients with Periorbital Spasm after Facial Nerve Paresis
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목적: 벨 마비와 외상 후 불완전 얼굴신경 회복 환자에서 나타난 눈 주변 근육 연축과 안면 비대칭의 임상 양상과 보툴리눔 독소 주사의치료 효과를 알아보았다. 대상과 방법: 2001년 11월부터 2010년 1월까지 불완전 얼굴신경 회복으로 얼굴 연축을 보이는 환자 17명을 대상으로 과거력, 보툴리눔독소 주사 용량과 부위, 횟수, 효과 지속 기간 등을 알아보았다. 결과는 Mann‐Whitney U test (SPSS 12.0)를 이용해 분석하였다. 결과: 보툴리눔 독소 치료는 평균 2.7 ± 2.4회 시행되었고, 단위부위별 용량은 평균 12.2 ± 1.2 unit였다. 주사 효과는 얼굴신경마비환자에서 평균 6.9 ± 5.5개월, 외상 환자에서 평균 8.0 ± 4.2개월간 지속되었으며, 두 그룹 간 유의한 차이는 없었다. 환자 대부분객관적, 주관적으로 모두 증상의 호전을 보였다. 합병증으로는 눈물흘림과 눈꺼풀처짐 증상이 있던 환자가 한 명씩 있었으며 이에대한 보존적 치료를 행하였다. 결론: 불완전 얼굴신경 회복 후 눈 주변 근육 연축과 얼굴 비대칭을 보이는 환자에서 보툴리눔 독소 주사로 연축을 완화시키고 얼굴대칭의 미용적 효과를 얻을 수 있다.
Abstract
Purpose: To evaluate clinical features of periorbital spasm and facial asymmetry in the patients who recovered poorly from Bell’s palsy and facial trauma and to investigate the effect of Botulinum toxin A as a treatment for periorbital spasm and facial asymmetry. Methods: Between November 2001 and January 2010, Botulinum toxin injection was performed in 17 patients who had blepharospasm and facial asymmetry following poor recovery from facial palsy. The past history, trauma history, clinical manifestation of blepharospasm, Botulinum toxin A injection dose, injection site, frequency of injection, and duration of effect was evaluated. Data was analyzed using the Mann-Whitney U test, SPSS 12.0Results: The mean number of injections was 2.7 ± 2.4 times and the mean dose per injection unit was 12.2 ± 1.2 units. The Botulinum toxin effect lasted 6.9 ± 5.5 months in Bell’s palsy patients, and 8.0 ± 4.2 months in trauma patients. There was no significant difference between the 2 groups. Most patients reported improvement of periorbital spasm and facial asymmetry. After treatment, 1 patient complained of epiphora and 1 patient complained of ptosis; conservative treatment was performed for these patients. Conclusions: Blepharospasm can be treated and a cosmetic improvement in facial symmetry can be achieved by Botulinum toxin A injection in the patients who recover poorly from facial palsy.
참고문헌 (20)
- Choi D, "Facial nerve repair and regeneration: an overview of basic principles for neurosurgeons", Acta Neurochir, 143, pp.107~114 (2001)
- Wang HC, "Post-traumatic hemifacial spasm", J Clin Neurosci, 13, pp.681~683 (2006)
- Borodic G, "Botulinum toxin for aberrant facial nerve regeneration: double-blind, placebo-controlled trial using subjective endpoints", Plast Reconstr Surg, 116, pp.36~43 (2005)
- Scott AB, "Botulinum A toxin injection as a treatment for blepharospasm", Arch Ophthalmol, 103, pp.347~350 (1985)
- Lee HD, "Management of essential blepharospasm: botulinum toxin a treatment and orbicularis myectomy operation", J Korean Ophthalmol Soc, 40, pp.3246~3252 (1999)
- Borodic GE, "Botulinum A toxin for treatment of aberrant facial nerve regeneration", Plast Reconstr Surg, 91, pp.1042~1045 (1993)
- Putterman AM, "Botulinum toxin injections in the treatment of seventh nerve misdirection", Am J Ophthalmol, 110, pp.205~206 (1990)
- Mehta RP, "Botulinum toxin and quality of life in patients with facial paralysis", Arch Facial Plast Surg, 10, pp.84~87 (2008)
- Kahn JB, "Validation of a patient- graded instrument for facial nerve paralysis: the FaCE scale", Laryngoscope, 111, pp.387~398 (2001)
- 유수병, "안윤근파동 환자에서 보툴리눔 독소의 치료 효과", 대한안과학회지, 48(6), pp.749~754 (2007), 대한안과학회
- 신재호, "본태눈꺼풀연축 환자에서 디스포트와 보톡스 효과 비교", 대한안과학회지, 50(3), pp.331~335 (2009), 대한안과학회
- McLoon LK, "Quantification of muscle loss in the doxorubicin-treated orbicularis oculi of the monkey", Invest Ophthalmol Vis Sci, 32, pp.1667~1673 (1991)
- McCord CD Jr, "Treatment of essential blepharospasm", Arch Ophthalmol, 102, pp.266~268 (1984)
- Frueh BR, "The effects of differential section of the VIITH nerve on patients with intractable blepharospasm", Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol, 81, pp.595~602 (1976)
- Jones TW Jr, "Myectomy for essential blepharospasm", Mayo Clin Proc, 60, pp.663~666 (1985)
- Bates AK, "Surgical management of essential blepharospasm", Br J Ophthalmol, 75, pp.487~490 (1991)
- Frueh BR, "Effects of eyelid protractor excision for the treatment of benign essential blepharospasm", Am J Ophthalmol, 113, pp.681~686 (1992)
- Anderson RL, "Surgical management of blepharospasm", Adv Neurol, 49, pp.501~520 (1988)
- 이태수, "본태안검연축에서 제한된 안윤근절제술의 임상효과", 대한안과학회지, 45(11), pp.2~2 (2004), 대한안과학회
- Borodic GE, "Orbicularis oculi myo-osseous fixation: a new treatment for benign essential blepharospasm and blepharospasm associated with diffuse facial dystonia", Ophthalmic Surg Lasers Imaging, 41, pp.360~369 (2010)