Digital Image Speckle Correlation to Optimize Botulinum Toxin Type A Injection: A Prospective, Randomized, Crossover Trial
| Autor: | Miriam Rafailovich, Gabriel Klein, Yan Xu, Duc T. Bui, Sami U. Khan, Alexander B. Dagum, Richa Verma, Juan Jose Gilbert Fernandez |
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| Rok vydání: | 2019 |
| Předmět: |
Diagnostic Imaging
Esthetics Injections Subcutaneous 030230 surgery Risk Assessment Botulinum toxin a law.invention 03 medical and health sciences Digital image 0302 clinical medicine Patient satisfaction Randomized controlled trial law Image Interpretation Computer-Assisted Paralysis medicine Humans Single-Blind Method Forehead Prospective Studies Botulinum Toxins Type A Prospective cohort study Aged Cross-Over Studies business.industry Speckle correlation Middle Aged Crossover study Skin Aging Treatment Outcome Patient Satisfaction 030220 oncology & carcinogenesis Surgery Female medicine.symptom business Nuclear medicine |
| Zdroj: | Plastic and reconstructive surgery. 143(6) |
| ISSN: | 1529-4242 |
| Popis: | Background Historically, physicians have relied on their subjective measures when determining the site and dosages for botulinum toxin type A injections. Digital image speckle correlation is a technology that tracks pore movement from rest to maximal exertion, allowing for the determination of the optimal sites of injection. In this prospective, randomized, crossover trial, the efficacy of using digital image speckle correlation was compared to physician assessment in choosing botulinum toxin type A injection sites. Methods Ten female patients were analyzed in this blinded crossover study. Subjects were randomized to either injections based on digital image speckle correlation analysis or injections based on the 2004 facial aesthetics consensus recommendations. All patients received 20 U of botulinum toxin type A in the glabellar region and were crossed over and reinjected after 6 months. Follow-up was completed with the Facial Line Outcomes 11-item survey and repeated imaging with digital image speckle correlation, to measure patient satisfaction and degree of paralysis, respectively. Statistical comparison was completed by means of matched sample t test. Results On average, the digital image speckle correlation analysis provided 4.8 injection sites, whereas the practitioner chose five injections sites. Patients receiving digital image-directed injections had higher rates of satisfaction on the Facial Line Outcomes instrument (p = 0.0003) and a larger degree of paralysis (p = 0.003). Furthermore, muscle function returned to normal later in patients injected with digital image speckle correlation (17.9 weeks versus 20 weeks; p = 0.03). Conclusions This study demonstrates the benefits of using digital image speckle correlation in determining optimal botulinum toxin type A injection location. Digital analysis allows practitioners to better treat facial rhytides by eliminating subjective decisions regarding dose and site of injection. Clinical question/level of evidence Therapeutic, II. |
| Databáze: | OpenAIRE |
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