Roberta D'Emilio, Mauro Barone, Riccardo De Bernardis, Rosa Salzillo, Giuseppe Rosati, Maria Grazia Caputo, Salvatore Piero Fundarò, Paolo Persichetti
{"title":"肉毒杆菌毒素:非肌无力轻至中度上睑下垂的非手术治疗方法。","authors":"Roberta D'Emilio, Mauro Barone, Riccardo De Bernardis, Rosa Salzillo, Giuseppe Rosati, Maria Grazia Caputo, Salvatore Piero Fundarò, Paolo Persichetti","doi":"10.1007/s00266-024-04584-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Mild-to-moderate blepharoptosis can be aesthetically displeasing for patients, particularly in cases involving a single eyelid. However, certain patients are reluctant to undergo surgical intervention. Botulinum neurotoxin A (BoNT-A) injection offers a potential solution in such cases.</p><p><strong>Material and methods: </strong>Patients meeting the following inclusion criteria were included in the study: mild-to-moderate eyelid ptosis of different etiologies (excluding myasthenic disorders), robust activity of the orbicularis oculi muscle, proficiency in Italian language, standardized pre- and postoperative photo-documentation, and signed consent for study participation. A 32-33 Gauge 4-mm needle was employed to inject the BoNT-A in the pretarsal orbicularis muscle. Standardized videos and photos were obtained before the treatment, 2 weeks, 4 weeks, and 24 weeks post-treatment. Outcomes were evaluated by measuring changes in the margin reflex distance-1 (MRD-1) and assessing patient point of view through two subjective questionnaires.</p><p><strong>Results: </strong>Forty-nine patients were enrolled, 39 females and 10 males, aged between 30 and 88 years old. We observed a significant increase in the MRD-1 after 2 weeks and after 4 weeks compared to the baseline (p < 0.0001), with a mean elevation of the eyelid of 0.71 mm and 0.67 mm respectively. Patients ceased to require furrowing of the frontalis muscle to compensate for the eyelid elevation dysfunction. After 24 weeks, the BoNT-A effect diminished, and the treated eyelid returned to its baseline position. 67.4% of patients reported an improvement with only mild inconvenience in their blepharoptosis, and 16.3% of patients reported a complete improvement. 85.7% of patients expressed the desire to undergo the treatment again.</p><p><strong>Conclusions: </strong>BoNT-A has demonstrated effectiveness in temporarily managing mild-to-moderate blepharoptosis and may represent a viable option for addressing minor eyelids asymmetries.</p><p><strong>Level of evidence ii: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Botulinum Toxin: A Non-surgical Approach for Non-myasthenic Mild-to-Moderate Blepharoptosis Treatment.\",\"authors\":\"Roberta D'Emilio, Mauro Barone, Riccardo De Bernardis, Rosa Salzillo, Giuseppe Rosati, Maria Grazia Caputo, Salvatore Piero Fundarò, Paolo Persichetti\",\"doi\":\"10.1007/s00266-024-04584-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Mild-to-moderate blepharoptosis can be aesthetically displeasing for patients, particularly in cases involving a single eyelid. However, certain patients are reluctant to undergo surgical intervention. Botulinum neurotoxin A (BoNT-A) injection offers a potential solution in such cases.</p><p><strong>Material and methods: </strong>Patients meeting the following inclusion criteria were included in the study: mild-to-moderate eyelid ptosis of different etiologies (excluding myasthenic disorders), robust activity of the orbicularis oculi muscle, proficiency in Italian language, standardized pre- and postoperative photo-documentation, and signed consent for study participation. A 32-33 Gauge 4-mm needle was employed to inject the BoNT-A in the pretarsal orbicularis muscle. Standardized videos and photos were obtained before the treatment, 2 weeks, 4 weeks, and 24 weeks post-treatment. Outcomes were evaluated by measuring changes in the margin reflex distance-1 (MRD-1) and assessing patient point of view through two subjective questionnaires.</p><p><strong>Results: </strong>Forty-nine patients were enrolled, 39 females and 10 males, aged between 30 and 88 years old. We observed a significant increase in the MRD-1 after 2 weeks and after 4 weeks compared to the baseline (p < 0.0001), with a mean elevation of the eyelid of 0.71 mm and 0.67 mm respectively. Patients ceased to require furrowing of the frontalis muscle to compensate for the eyelid elevation dysfunction. After 24 weeks, the BoNT-A effect diminished, and the treated eyelid returned to its baseline position. 67.4% of patients reported an improvement with only mild inconvenience in their blepharoptosis, and 16.3% of patients reported a complete improvement. 85.7% of patients expressed the desire to undergo the treatment again.</p><p><strong>Conclusions: </strong>BoNT-A has demonstrated effectiveness in temporarily managing mild-to-moderate blepharoptosis and may represent a viable option for addressing minor eyelids asymmetries.</p><p><strong>Level of evidence ii: </strong>This journal requires that authors assign a level of evidence to each article. 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Botulinum Toxin: A Non-surgical Approach for Non-myasthenic Mild-to-Moderate Blepharoptosis Treatment.
Introduction: Mild-to-moderate blepharoptosis can be aesthetically displeasing for patients, particularly in cases involving a single eyelid. However, certain patients are reluctant to undergo surgical intervention. Botulinum neurotoxin A (BoNT-A) injection offers a potential solution in such cases.
Material and methods: Patients meeting the following inclusion criteria were included in the study: mild-to-moderate eyelid ptosis of different etiologies (excluding myasthenic disorders), robust activity of the orbicularis oculi muscle, proficiency in Italian language, standardized pre- and postoperative photo-documentation, and signed consent for study participation. A 32-33 Gauge 4-mm needle was employed to inject the BoNT-A in the pretarsal orbicularis muscle. Standardized videos and photos were obtained before the treatment, 2 weeks, 4 weeks, and 24 weeks post-treatment. Outcomes were evaluated by measuring changes in the margin reflex distance-1 (MRD-1) and assessing patient point of view through two subjective questionnaires.
Results: Forty-nine patients were enrolled, 39 females and 10 males, aged between 30 and 88 years old. We observed a significant increase in the MRD-1 after 2 weeks and after 4 weeks compared to the baseline (p < 0.0001), with a mean elevation of the eyelid of 0.71 mm and 0.67 mm respectively. Patients ceased to require furrowing of the frontalis muscle to compensate for the eyelid elevation dysfunction. After 24 weeks, the BoNT-A effect diminished, and the treated eyelid returned to its baseline position. 67.4% of patients reported an improvement with only mild inconvenience in their blepharoptosis, and 16.3% of patients reported a complete improvement. 85.7% of patients expressed the desire to undergo the treatment again.
Conclusions: BoNT-A has demonstrated effectiveness in temporarily managing mild-to-moderate blepharoptosis and may represent a viable option for addressing minor eyelids asymmetries.
Level of evidence ii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
期刊介绍:
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.