Botox injections improve facial symmetry after nerve transfer surgery

For patients undergoing nerve transmission surgery for face paralysis, Botox injections can improve facial symmetry by reducing excessive muscle activity on the unaffected side, indicating a study in his March issue Plastic and Reconstructive Surgery^®; The official medical journal of the American Society of Plastic Surgeons (ASPS). The magazine is published in the Lippincott portfolio by Wolters Kluwer.

The additional advantage of Botox reflects the modifications to the connectivity of the brain’s operating network, according to the new study, led by their Ye-Chen Lu, MD, PhD and Wei Wang, MD, PhD, University of Shanghai School of Medicine Jiao Tong. They write: “These findings suggest that enhanced connectivity between functional brain networks plays a vital role in the process of recovery by neurological disorders.”

Bont-A improves the results of surgery for facial paralysis

Facial nerve damage can cause paralysis on the affected side of the face, leading to functional and cosmetic damage. For patients with this condition, nerve transfer surgery is recommended to restore the function of the facial nerve and symmetry.

However, many patients have persistent weakening after surgery, especially the fall of the angle of the mouth (oral commissure) on the affected side. This condition is linked to muscle hyperactivity on the opposite side, leading to facial asymmetry even to calm.

These patients have undergone successful treatment using Botulinum-A toxin (Bont-A, known as Botox brand) to produce temporary relaxation of superractive muscles on the unaffected side. Previous studies indicate a constant improvement, even after the effects of the BONT-A FADE.

Benefits associated with changes in brain network connectivity

“We assume that BONT-A Treatment causes extensive plasticity of the bark, offering a possible explanation for its long-term therapeutic effects in patients with facial asymmetry“Researchers write. They used functional magnetic resonance (FMRI) scans to evaluate the functional activity of brain networks before and after surgery and bont-a treatment.

The study included 38 patients with facial paralysis and “severe oral projection” after surgery for benign tumors (acoustic ribs). Everyone underwent nerve surgery followed by training and facial rehabilitation. In addition, patients were accidentally assigned to a treatment group that received a series of injections of Bont-a facial muscles on the unwanted side. or a control group that does not receive bont-a.

Patients who received Bont-A had a significant improvement in facial asymmetry. “Bont-a injections have improved static face function without affecting the function of the smile,” the researchers write. As in previous studies, the benefits were still over six months, as the effects of Bont-A wore.

Before surgery and a year later, patients underwent FMRI scanning to evaluate changes in the connectivity of the brain functional network. Of the nine rest of RSNS (RSNS), five showed “significant spatial distribution differences” between the groups. Patients receiving bont-A “have had a comprehensive more powerful interaction between several RSNs”-mainly including aesthetic and visual networks.

“Our research provides data on long -term and widespread changes in brain networks among patients with paralysis of the face“Drs Lu and Wang and Coauthors write. These results can explain why the improvement still remains after the effects of bont-a dissolve.

BONT-A injections can create a “time window to reappear the nerve, allowing the brain to learn and restore appropriate facial muscle activity. “Researchers conclude:”These findings suggest that enhanced connectivity between functional brain networks plays a vital role in the process of recovery by neurological disorders. ”