title: Contralateral botulinum injections in patients with residual facial asymmetry and contralateral hyperkinesis after primary facial palsy surgery.
abstract: OBJECTIVE
  In patient with facial paralysis, facial appearance and muscular ability are impaired, and the psychological integrity is affected. Botulinum toxin A may be used to improve facial symmetry in patients suffering with facial palsy reducing the progressive contralateral hyperkinesis and facial asymmetry after primary surgery for facial paralysis.
  
  
  METHODS
  Six patients, whom have been suffering unilateral facial palsy with an House-Brackmann score grade from III to VI, were included in this study for a residual facial asymmetry and contralateral hyperkinesis after previous facial reanimation. They were treated with 50 units of botulinum toxin type A injected in muscles of the unaffected side of face to improve muscular ability and facial symmetry.
  
  
  RESULTS
  This study demonstrated reduction in contralateral hyperkinesis and facial asymmetry that lasted approximately 120 days. All patients reported satisfactory results with the treatment.
  
  
  CONCLUSIONS
  Botulinum toxin type A injections improved facial asymmetry and muscular function in all patients.
  
  
  CONCLUSIONS
  Botulinum toxin type A injections may be an indispensable technique as a nonsurgical treatment or as a complementary measure in postsurgical treatments and should be certainly considered for temporary or permanent asymmetries in patients who suffer from facial palsy.
  
  
  CONCLUSIONS
  Contralateral botulinum toxin type A injection was useful in reducing muscular hyperkinesis in patients with residual facial asymmetry after primary surgery for facial palsy, improving aesthetic and functional facial recovery with not widely common adverse events.
authors.forename: Davina
authors.initials: D
authors.lastname: Bartoli
authors.forename: Andrea
authors.initials: A
authors.lastname: Battisti
authors.forename: Andrea
authors.initials: A
authors.lastname: Cassoni
authors.forename: Valentina
authors.initials: V
authors.lastname: Terenzi
authors.forename: Marco
authors.initials: M
authors.lastname: Della Monaca
authors.forename: Mario
authors.initials: M
authors.lastname: Pagnoni
authors.forename: Valentino
authors.initials: V
authors.lastname: Valentini
authors.forename: Paolo
authors.initials: P
authors.lastname: Priore
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005146:Facial Asymmetry / Q000188:drug therapy*; D005158:Facial Paralysis / Q000601:surgery*; D006801:Humans; D006948:Hyperkinesis / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000627:therapeutic use*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A