持续的肌源性关节障碍:导航导向的肉毒素A注射到侧侧肌肉是有效的吗?
Alexis Martenot1, Jean-François Devoti2, Mélanie Pons1
1Université de Franche-Comté, CHU Besançon, Chirurgie maxillo-faciale, stomatologie et odontologie hospitalière, Besançon F-25000, France.
Journal of stomatology, oral and maxillofacial surgery
|November 28, 2023
概括
毒素-A注射在侧面状肌肉中有效地减少了疼痛,并改善了持续性关节障碍的口腔开口. 用MR引导的导航确保了安全和准确的交付,提供了一个有前途的治疗选择.
科学领域:
- 神经学 神经学
- 矯正牙科 矯正牙科是一種矯正牙科.
- 放射学 放射学是一门学科.
背景情况:
- 持久性肌源性部部疾病 (M-TMDs) 经常抵抗保守治疗.
- 侧肌 (LPM) 是M-TMD的关键肌肉,但很难获得注射.
- 毒素-A (BTX-A) 对M-TMDs有效,但由于访问挑战,LPM注射并不常见.
研究的目的:
- 评估BTX-A注射在LPM中对持久性M-TMDs的有效性.
- 评估LPM BTX-A注射MR引导导航的安全性和可靠性.
- 分析注射后疼痛,口腔开口和关节声音的改善.
主要方法:
- 对34名患有持续性M-TMD的患者进行了回顾性研究,他们接受了51次BTX-A注射.
- 由MRI成像指导的LPM注射;临床指导的masseter和temporalis注射.
- 在注射后的1个月和3个月,评估疼痛强度,最大口腔口腔 (MIO) 和关节声音.
主要成果:
- 在LPM注射BTX-A可显著降低疼痛强度,在1个月后降低65%,在3个月后降低49%.
- 3个月后平均MIO的统计显著改善,关节声音从41.2%减少到9.7%.
- 63%的患者报告主观完全改善;没有观察到任何显著的不良事件.
结论:
- 通过MR引导的导航,可以准确,可靠和安全地将BTX-A注入到M-TMD的LPM中.
- 该方法在持续性M-TMDs的症状改善方面显示出令人鼓舞的结果.
- 需要进一步的研究,以建立可复制,安全和具有成本效益的LPM可访问性方法用于临床实践.
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