title: Botulinum toxin for radiation-induced facial pain and trismus.
abstract: OBJECTIVE
  To report the efficacy of botulinum toxin A for radiation-induced pain, trismus, and masticator spasm in head and neck cancer.
  
  
  METHODS
  This prospective nonrandomized study included patients in complete remission with radiation-induced pain and trismus with or without masticator spasms. Fifty units of Botox (Allergan) or 250 units of Dysport (Ipsen) were injected transcutaneously into the masseter muscles. Jaw opening was measured and patients answered 20 questions about jaw opening, pain, and cramps, before injection at 1 month.
  
  
  RESULTS
  Nineteen patients (7 women, 12 men) were included. Median time after radiation therapy was 5 years (range, 11 months to 22 years). At 1 month, no significant increase in jaw opening was recorded. Improvement was noted in the functional domain (P = 0.004), for pain (P = 0.002) and cramps (P = 0.004), but not in the social (P = 0.83) or emotional (P = 0.43) domains. No side effects occurred.
  
  
  CONCLUSIONS
  Botulinum toxin did not improve trismus but significantly improved pain scores and masticator spasms (oromandibular dystonia).
authors: Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France. dana.hartl@igr.fr
authors: Dana M
authors: DM
authors: Hartl
authors: Myriam
authors: M
authors: Cohen
authors: Morbize
authors: M
authors: Juliéron
authors: Patrick
authors: P
authors: Marandas
authors: Franéois
authors: F
authors: Janot
authors: Jean
authors: J
authors: Bourhis
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005157:Facial Pain / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D014313:Trismus / Q000188:drug therapy*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A