Botulinum toxin in the treatment of post-radiosurgical neck contracture in head and neck cancer: A novel approach
| Autor: | Bertrand Baujat, I. Wagner, Frédéric Chabolle, C.-A. Bach, X. Lachiver |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Contracture Pain Pilot Projects Cancer sequelae Postoperative Complications medicine Humans Cervical dystonia Botulinum Toxins Type A Radiation Injuries Aged Muscle contracture Neck pain business.industry Head and neck cancer Middle Aged medicine.disease Botulinum toxin Fibrosis Surgery Radiation therapy Muscle relaxation Neuromuscular Agents Otorhinolaryngology Head and Neck Neoplasms Anesthesia Female medicine.symptom business Sternocleidomastoid muscle medicine.drug |
| Zdroj: | European Annals of Otorhinolaryngology, Head and Neck Diseases. 129(1):6-10 |
| ISSN: | 1879-7296 |
| DOI: | 10.1016/j.anorl.2011.07.002 |
| Popis: | Summary Neck pain affects a third of patients following head-and-neck cancer treatment, whether by radiation therapy or surgery. It is a disabling condition and the associated muscle contractures impair cervical motion. Type-A botulinum toxin is an analgesic and muscle relaxant, able to improve patients’ quality of life. We here report our experience with botulinum toxin in post-radiosurgical neck contracture. Patients and methods A single-center pilot study was run from January 2007 to July 2008, respecting the Declaration of Helsinki. All patients in complete remission from head-and-neck cancer with post-radiosurgical neck contracture impairing neck motion were included. Pain and functional impairment were assessed on a neck-function disability scale before and 1 month after botulinum toxin injection. Efficacy duration was measured. Complications at the injection site or related to drug diffusion were investigated. Results Nine consecutive patients (six male, three female; mean age, 61 years [range, 52–73 years]) were included. In six patients, the sternocleidomastoid muscle was injected and the muscular pedicle of a pectoralis major flap in three. Mean cervical disability score fell significantly from 33 to 23 ( P = 0.01). There were no complications. Efficacy was seen at a mean 6 days, and analgesia and muscle relaxation lasted for a mean 19 days. Conclusion In post-radiosurgical neck contracture, botulinum toxin injection is a simple and easy procedure able to improve neck motion and reduce neck pain in head-and-neck cancer patients. A phase-II prospective study to determine injection sites and dosage should help bear out these preliminary findings. |
| Databáze: | OpenAIRE |
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