For patients undergoing nerve transfer surgery, Botox injections can improve Plastic and reconstructive surgery®, the official medical magazine of the American Society of Plastic Surgeons (ASP). The magazine is published in the Lippincott portfolio by Wolters Kluwer.
Botox’s additional benefit reflects modifications in the connectivity of the brain functional network, the new research chord, directed by Ye-Chen Lu, MD, PHD and Wei Wang, MD, PHD or Shanghai Jiao Tong University School of Medicine, China. They write: “These findings imply that the improved connectivity between brain functional networks plays a vital role in the recovery process of neurological disorders.”
BONT-A improves the results of surgery for facial paralysis
The facial nerve injury can cause paralysis on the affected side of the face, which leads to functional and cosmetic impediments. For patients with this condition, nerve transfer surgery is recommended to restore the function and symmetry of the facial nerve.
However, many patients have persistent deterioration after surgery, especially the corner of the corner (oral commissure) on the affected side. This condition has a leg linked to the hyperactivity of the muscles on the opposite side, which leads to facial asymmetry even in the rest.
These patients have been successfully treated using toxin-a botulinum (bont-a; better known by the Botox brand) to produce the temporal relaxation of the hyperactive muscles on the unabled side. Previous studies suggest a lasting improvement, even after the effects of bont-a fading.
Benefits linked to changes in cerebral network connectivity
“We presume that the treatment of Fur-A triggers an extensive cortical plasticity, offering a possible explanation of its long-term therapeutic impact in patients with facial asymmetry,” the researchers write. They used functional magnetic resonance scan (FMRI) to evaluate the functional activity of brain networks before and after surgery and treatment with bont-a.
The study included 38 patients with facial paralysis and “severe oral commissure fall” after surgery for benign tumors (acoustic neuromas). All underwent nerve transfer surgery followed by facial training and rehabilitation. In addition, the patients were randomly assigned to a treatment group that received a series of bont-a injections of the facial muscles on the unabled side; Or a control group that did not receive Bont-A.
Patients who received Bont-A had a significant improvement in facial asymmetry. “Bont-a injections improved facial static function without affecting the function of the smile,” the researchers write. As in previous studies, the benefits persisted beyond six months, after the effects of Bont-A Ware.
Before surgery and a year later, patients underwent FMRI scans to the evaluation changes in the connectivity of the brain functional network. Or nine state resting networks (RSN) studied, five showed “significant differences or spatial distribution” between the groups. Patients who received Bont-A “showed a stronger general interaction between several RSN”, no doubt, including sensori-mounted and visual networks.
“Our research provides evidence of generalized and generalized changes in brain networks between patients with facial paralysis,” writes Lu and Wang and co -authors. These effects can explain why the improvement persists just after the effects of the skin-A dissipate.
Fur-A injections “can create a” time window for nerve resuscitation, allowing the brain to learn and restore adequate facial muscle activity.
Plastic and reconstructive surgery® is published by Wolters Kluwer.
Click here to read “Improvement of facial symmetry and brain network modifications in patients with facial paralysis after treatment with type A botulinum toxin”
Article: “Improvement of facial symmetry and modifications of the brain network in patients with facial paralysis after treatment with type A botulinum toxin” (DOI: 10,1097/PRS.00000000011689)
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