Severe Dysphagia After Inferior Alveolar Nerve Block Preceded By Cervical Botolinum Toxin Injection: A Case Report

Abstract

A 39-year-old Iranian female patient who was a known case of primary cervical dystonia since 10 years ago presented to a private office for Dysport injection. The patients experienced severe dysphagia after inferior alveolar nerve block which was preceded by cervical botolinum toxin injection. A possible synergistic effect of botolinum toxin and lidocaine to produce severe dysphagia is presented in this case report.

Specific characteristics of the medical history of swallowing before and after application of botulinum toxin in patients with cervical dystonia

“…Figure 1 shows that the presence of coughing or gagging while eating was the most frequent complaint before 9 and after 11 BTX injection. The curves of both graphs have similar shapes, showing an increase in the number of complaints of requiring extra effort to swallow solids, sensation of food stuck in the throat, and eating fatigue.…”

“…Dysphagia is described as one of the most frequent side effects of BTX injection, with an occurrence rate ranging from 10-90% 5 , 8 , 9 , which can be reduced using ultrasound and electromyography to guide the BTX injection 8 . Despite the large number of citations and high variability of results, few studies have assessed swallowing in these individuals before and after treatment 10 - 12 .…”

Sinonasal Ameloblastoma: A Case Report and a Review of Gnathic Lesions That Occur in the Sinonasal Tract

“…Ameloblastomas (AMs) are the most common gnathic odontogenic neoplasms 1 . These lesions are benign, typically occur in either the maxilla or mandible, and are locally aggressive 2–10 . Between 2% and 10% of AMs are found in extragnathic sites 10 .…”

“…Gnathic AMs typically present in the third to fifth decade of life with no sex predilection 5,8,10,11 . In contrast, SNAMs present in older, mostly male patients in the sixth to eighth decade of life 3,5,9,10,18 . Patients present with progressive nasal obstruction, chronic sinusitis, epistaxis, rhinorrhea, hemifacial paresthesia, and facial pain 2,9–11,15,19 .…”

“…In contrast, SNAMs present in older, mostly male patients in the sixth to eighth decade of life 3,5,9,10,18 . Patients present with progressive nasal obstruction, chronic sinusitis, epistaxis, rhinorrhea, hemifacial paresthesia, and facial pain 2,9–11,15,19 . The symptoms at presentation depend on the size and location of the tumor 15,16 .…”