title: Treatment of pectoralis major flap myospasms with botulinum toxin type A in head and neck reconstruction.
abstract: BACKGROUND
  Treatment options for muscle spasm complications of the pectoralis major (PM) flap in head and neck reconstruction have hardly been investigated. The authors report their experience using botulinum toxin (BTX-A) injections as a treatment of PM flap myospasm complications in head and neck reconstruction.
  
  
  METHODS
  From January 2005 to May 2009, 83 patients underwent PM flap reconstruction. Eleven of them reported muscle twitching as a post-operative complication and are therefore included in this study. As all 11 patients refused a second surgery, they were offered BTX-A injections. This group of patients was followed up at regular intervals with clinical examinations, digital photography, range of motion (ROM) of the neck in different vectors, and neck disability system (NDS) questionnaires.
  
  
  RESULTS
  After the first BTX-A infiltration, muscle twitching decreased, the ROM values increased and, according to the NDS, patients' discomfort progressively decreased. Only two of the 11 patients required two additional BTX-A sessions.
  
  
  CONCLUSIONS
  BTX-A infiltration is an effective non-invasive procedure that significantly reduces the PM muscular contraction in head and neck reconstruction.
authors.affiliation: China Medical University Hospital, Department of Plastic and Reconstructive Surgery, 2 Yuh-Der Road, Taichung, 40447, ROC, Taiwan.
authors.forename: Emilio
authors.initials: E
authors.lastname: Trignano
authors.forename: Luca A
authors.initials: LA
authors.lastname: Dessy
authors.forename: Nefer
authors.initials: N
authors.lastname: Fallico
authors.forename: Antonio
authors.initials: A
authors.lastname: Rampazzo
authors.forename: Bahar
authors.initials: B
authors.lastname: Bassiri
authors.forename: Marco
authors.initials: M
authors.lastname: Mazzocchi
authors.forename: Nicolò
authors.initials: N
authors.lastname: Scuderi
authors.forename: Hung-Chi
authors.initials: HC
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006257:Head; D006801:Humans; D007273:Injections, Intramuscular; D008875:Middle Aged; D009333:Neck; D009465:Neuromuscular Agents / Q000008:administration & dosage; D010369:Pectoralis Muscles; D011183:Postoperative Complications / Q000188:drug therapy / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D013035:Spasm / Q000628:therapy*; D013524:Surgical Flaps; D060053:Transplant Donor Site / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A