肌内注射A型肉毒杆菌毒素治疗颞下颌关节紊乱的Meta分析研究

Q4 Medicine

Egyptian Journal of Ear, Nose, Throat and Allied Sciences Pub Date : 2022-01-01 DOI:10.21608/ejentas.2022.167208.1567

Ayman El-Kahky, T. Hamdy, Mohamed S. El-Tantawy, A. Askoura

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引用次数: 0

摘要

肉毒杆菌毒素是一种由革兰氏阳性的厌氧芽孢形成细菌肉毒梭菌产生的神经毒素，最近通过暂时抑制咀嚼肌肉作为一种有效和安全的治疗颞下颌关节疾病(TMDs)的方法。TMDs是一个非特异性术语，用于描述涉及TMJ、咀嚼肌和/或相关结构的疾病。工作目的:进行了一项荟萃分析，以评估肌内注射肉毒毒素A (BTX-A)治疗肌源性颞下颌关节(TMJ)疾病的疗效。患者和方法:系统地检索了过去25年内发表的有关人类的研究。文献检索包括PubMed、Medline、Scopus、Web of science、EBSCOhost、Cochrane等数据库。该研究包括已发表的关于肌源性TMD患者肌内注射肉毒杆菌毒素a的医学文章。在荟萃分析中汇总了类似研究的结果。结果:我们的系统综述纳入了39项1538名参与者的研究，其中23项研究纳入了meta分析。目前的研究显示，肌肉注射BTX-A(治疗前和治疗后)和BTX-A与对照组相关的1个月和3个月的VAS(视觉模拟量表)评分差异具有统计学意义。BTX-A与对照组在1、3个月时的最大开口数(MMO)差异无统计学意义。BTX-A与对照组在1个月时的肌电振幅差异无统计学意义，而在3个月时有统计学意义。BTX-A与对照组在3个月和6个月时最大咬合力的变化具有统计学意义。结论:现有数据支持肌内注射BTX-A治疗肌源性TMD的疗效，未来需进一步进行随机对照研究。

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Meta Analytical Study of the Role of Intramuscular Botulinum A Toxin Injection in the Treatment of Temporomandibular Joint (TMJ) Disorders

Introduction: Botulinum toxin is a neurotoxin produced by a gram-positive, anaerobic spore-forming bacterium called Clostridium botulinum recently used as an effective and safe line of treatment for the temporomandibular joint disorders (TMDs) through temporarily inhibition of the masticatory muscles. TMDs is a collective non-specific term used to describe disorders that involve the TMJ, masticatory muscles and/or associated structures. Aim of the Work: A meta-analysis was conducted to evaluate the efficacy of intramuscular Botulinum toxin-A injection (BTX-A) in the treatment of myogenic temporomandibular joint (TMJ) disorders. Patients and Methods: A systematic literature search was done to identify relevant studies published within the last 25 years on humans. Literature search had been done including PubMed, Medline, Scopus, Web of science, EBSCOhost and Cochrane databases. The study included published medical articles about intramuscular botulinum toxin-A injection in patients suffering from myogenic TMD. The results of the similar studies were pooled in the meta-analysis. Results: Thirty-nine studies with 1538 participants were included in our systematic review and 23 of these studies were pooled in the meta-analysis. The current study showed that the difference of VAS (visual analogue scale) score at 1 and 3 months associated with intramuscular BTX-A injection (pre- and post-treatment) and BTX-A versus control is statistically significant. The difference of MMO (maximum mouth opening) at 1 and 3 months between BTX-A and control is not statistically significant. The difference of EMG amplitude at 1 month between BTX-A and control is not statistically significant while at 3 months is statistically significant. The change in maximum bite force at 3 and 6 months between BTX-A and control is statistically significant. Conclusion: The available data favors the efficacy of usage of intramuscular BTX-A injection in cases of myogenic TMD, further randomized controlled studies must be conducted in the future.

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来源期刊

Egyptian Journal of Ear, Nose, Throat and Allied Sciences Medicine-Otorhinolaryngology

CiteScore

0.20

自引率

0.00%

发文量

期刊介绍： Egyptian Journal of Ear, Nose, Throat and Allied Sciences aspires to play a national, regional and international role in the promotion of responsible and effective research in the field of Otolaryngology, Head and Neck Surgery in Egypt, Middle East and Africa. Mission To encourage and support research in Ear, Nose and Throat (ENT) field and interdisciplinary topics To implement high-quality editorial practices among Otolaryngologists To upgrade the ability and experience of local doctors in international publishing To offer professional publishing support to local researchers, creating a supportive network for career development To highlight ENT diseases and problems peculiar to our region To promote research in endemic, hereditary and infectious ENT problems related to our region To expose and study impact of ethnic, social, environmental and cultural issues on expression of different ENT diseases To organize common epidemiologic research of value to the region To provide resource to national and regional authorities about problems in the field of ENT and their implication on public health and resources To facilitate exchange of knowledge in our part of the world To expand activities with regional and international scientific societies.