Use of botulinum toxin in cheiloplasty: A new method to decrease tension

Abstract

Objective To determine if the use of botulinum toxin during cheiloplasty could help in the management of tension at the surgical wound level. Interventions Five children younger than six months of age, who were born with complete cleft lip and palate, were treated with a dose of 10 units of botulinum toxin injected into the upper lip during surgery. Before the surgery, an electromyographic study was carried out on the patients' upper lips. A Millard-type cheiloplasty was performed and 10 days later, a second electromyographic study was performed on the upper lips of all the patients. Results There was a significant change (P<0.039) in the electromyo-graphic tracing obtained after the application of botulinum toxin, especially during rest. Conclusion As confirmed by electromyography, botulinum toxin effectively inhibits the action of the orbicularis oris muscle, especially when at rest; consequently, the tension is decreased at the level of the surgical wound.

Effect of Preoperative inhibition of Orbicularis Oris Muscle action On Philtrum length in primary Cleft Lip Repair

“…11 Nine years after the work of Revera et al, Galarraga confirmed the inhibition of the orbicularis oris muscle by using BTX during cleft lip repair by the EMG. 12 The results of our study, presence of less difference between the cleft and the non-cleft sides in the BTX group came in agreement with the previous conclusion that the orbicularis oris muscle increased activity correlates to shorter lip and inhibiting this activity may prevent the complication of shorter incompetent lip.…”

“…Although Chang et al used the BTX at the end of the cheiloplast surgery. Galárraga 12 also had a different opinion as he considered the intraoperative administration of BTX-A is appropriate because the children frequently suffer from upper respiratory tract infections that often delay the surgeries.…”

Botulin Toxin Use in Scars/Keloids Treatment

“…BTX has been used to treat hypertrophic scars (HS) and keloids in a number of studies [8], [9], [10], [11], [12], [13], [14] and also was successfully used in scar prevention [14], [15], [16], [17], [18], [19], [20], [21]. Only a small number of available studies were made as randomized controlled trials with the efficacy of BTX compared to placebo (saline solution) or steroids, and those studies differ for the amount of BTX used ranging from 1.5 to 5 IU every cm2 and for the frequency of treatment ranging from a single treatment to multiple treatments done every month or even with longer intervals, but all gave positive results.…”

The use of botulinum toxin type A to minimize scarring in cleft lip repair: A literature review

“…Although the scars were reported to be satisfactory, the study lacked any subjective or objective scar assessment tools to support such a conclusion. Galarraga [21] showed that intraoperative BTA injections significantly reduced orbicularis oris activity when measured by electromyography. An electromyographic study was conducted in the upper lip of five infants (aged < 6 months) before surgery.…”