Botulinum toxin for radiation-induced facial pain and trismus.
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).
Hartl
Dana M
DM
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France. dana.hartl@igr.fr
Cohen
Myriam
M
Juliéron
Morbize
M
Marandas
Patrick
P
Janot
Franéois
F
Bourhis
Jean
J
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*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A