Nb. Bikhazi et Cs. Maas, REFINEMENT IN THE REHABILITATION OF THE PARALYZED FACE USING BOTULINUM TOXIN, Otolaryngology and head and neck surgery, 117(4), 1997, pp. 303-307
A number of surgical procedures exist to improve facial symmetry for p
atients with facial paralysis. Whereas static symmetry is often improv
ed, dynamic asymmetry frequently persists because of the imbalance of
complex coordinated movements of facial expression, The paralyzed face
is often distorted by the excessive pull of the normal contralateral
face during emotional expression, This study reports an expanded clini
cal indication for botulinum toxin in patients with unilateral facial
paralysis. Ten patients with facial paralysis and markedly asymmetric
smiles were treated with botulinum toxin A injections into the contral
ateral zygomaticus major, levators labii superioris and angulii oris,
or risorius muscles. Eight of the 10 patients noted improvement in the
symmetry of their smiles and underwent repeat injections. The onset a
nd duration of effect averaged 5.9 days and 3 months, respectively, Bo
tulinum toxin therapy provides a safe and efficacious modality for ref
ining the appearance of the paralyzed face during mimetic activity.