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Botulinum toxin A may help create lower-lip symmetry in children with facial paralysis

Botulinum toxin A injections were found to help correct lower-lip asymmetry in pediatric patients with facial paralysis, with no major complications, according to researchers.

Siba Haykal

The researchers retrospectively reviewed medical records for 18 patients with facial paralysis who were treated with botulinum toxin A injections between Jan. 1, 2004, and Dec. 31, 2012, and had a minimum 2 years of follow-up following their last injection. Eleven of the patients were treated for focal lip asymmetry, five were treated for extensive hemifacial asymmetry and five were treated for focal synkinesis. Patients’ mean age was 11.2 years.

Facial analysis software developed by the Massachusetts Eye and Ear Infirmary was utilized to evaluate facial symmetry by measuring the patients’ lip deviation, which the researchers defined as the difference in vertical aperture between the paralyzed and nonparalyzed sides of the lip, in each photograph.

Patients in the focal lip asymmetry group received a mean 3.6 botulinum toxin A injections, compared with 8.4 injections in the hemifacial group and 7.3 injections in the focal synkinesis group.

The researchers reported a pretreatment mean dynamic deviation of 3.5 mm and a post-treatment mean dynamic deviation of 1.5 mm, for a significantly significant mean deviation correction of 61%. Median time between botulinum toxin A treatments was 4 months. No patients experienced complications during the 2 years following the last injection, according to the researchers. – by Abigail Sutton

Disclosure: The researchers report no relevant financial disclosures.