Use of botulinum toxin in cheiloplasty: A new method to decrease tension

Area of Science:

• Plastic Surgery
• Pediatric Surgery
• Neuromuscular Medicine

Background:

• Cleft lip and palate repair (cheiloplasty) can be complicated by muscle tension at the surgical site.
• Managing this tension is crucial for optimal wound healing and aesthetic outcomes in infants.

Purpose of the Study:

• To evaluate the efficacy of botulinum toxin in reducing surgical wound tension during cheiloplasty.
• To assess the impact of botulinum toxin on orbicularis oris muscle activity in infants undergoing cleft lip repair.

Main Methods:

• A prospective study involving five infants under six months with complete cleft lip and palate.
• Electromyography (EMG) was performed before and 10 days after cheiloplasty with botulinum toxin (10 units) injection into the upper lip.
• Millard-type cheiloplasty was the surgical technique employed.

Main Results:

• A statistically significant change (P<0.039) in EMG readings was observed post-botulinum toxin application.
• The reduction in muscle activity was particularly notable during periods of rest.
• Botulinum toxin effectively inhibited the orbicularis oris muscle's action.

Conclusions:

• Botulinum toxin administration during cheiloplasty effectively reduces tension at the surgical wound level.
• Electromyographic evidence supports the role of botulinum toxin in inhibiting the orbicularis oris muscle, especially at rest.
• This intervention shows promise for improving outcomes in cleft lip and palate repair by managing muscle-related wound tension.