• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.1
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• pp.9-11
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• 2019

Botulinum toxin (BTX) has been widely used to treat muscle spasms in many voice disorders. Most commercially available forms of BTX require reconstitution before use, which may increase the risk of contamination and requires careful titration. Recently, a liquid-type BTX type A (BTX-A) has been developed, which should simplify the procedure and enhance its efficacy. In this session, I will discuss about the differences of BTX-A from existing types and the practical issues associated with it.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.3
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• pp.231-237
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• 2014

Botulinum toxin has been used for treating chronic migraine under US Food and Drug Administration approval since 2010. However there is no definitive guideline for injection point. The aim of this study is to propose an effective and safe injection guideline by reviewing the previous studies.

• Therapeutic Science for Rehabilitation
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• v.5 no.1
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• pp.67-75
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• 2016

Objective : This study was examined the effects of task-oriented training therapy after botulinum toxin injection, upper extremity function and activities of daily living for stroke patient. Methods : The subject was a 44 year old male who suffered from hemiplegic patient received a task-oriented training therapy after botulinum toxin injection on involved upper extremity for 30-min sessions 5 times every week during 8 weeks. The scores were obtained before the injection, at 4 weeks, and 8 weeks after the injection. The upper extremity function was assessed using a Manual Function Test and Box and Block Test, and also Modified Barthel Index was applied for evaluation of Activities of Daily Living performance ability. Results : The results of this study show that the subject's In-hand manipulation and dexterity function increase significantly. Also, In activities of daily living, personal hygiene area, feeding area, toilet area, dressing area scores are improved significantly. Conclusion : Through this study, task-oriented training after botulinum toxin injection can improve upper extremity function and Activities of Daily Living performance ability of patient with stroke.

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.121-129
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• 2005

In this experiment, eleven volunteers were followed up for 15 months after the injection of botulinum toxin type A on right and left masseter muscles. The measurement of masseter muscle atrophy for each volunteer was performed by CT(computed tomography) three times: before the injection, three and fifteen months after the injection. The thickness and area of muscle were measured in three positions which are 10 (position 1), 20 (position 2), and 40 mm (position 3) above the inferior border of mandible(the injection site was nearest the position 1). The thickness of masster muscle was decreased in all three positions three months after the injection, but no significant change was observed fifteen months after the injection. On the other hand, the area of masster muscle was decreased in all three positions three months after the injection. Furthermore, the area was decreased significantly in positions 1 and 2, but not in position 3 fifteen months after the injection. As a result, toxin is still in effect even fifteen months after the injection. Finally, the present study shows that the measurement of muscle area provides more precise informations than that of muscle thickness does.

• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.69-77
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• 2006

Botulinum toxin injection has been used in the masticatory muscle area as an effective treatment method of various movement disorders and facial contouring, but its effects on jaw function have not been evaluated. The aims of this study were to evaluate the effects of botulinum toxin type A injection into the masseter muscle on the EMG activities of masseter and anterior temporal muscles, and the limitation of jaw function. Fourteen healthy subjects were recruited. Five subjects were injected with 80 units of botulinum toxin type A(Dysport, Ipsen, Wrexham, UK) into each side of masseter muscle, and nine subjects were injected with saline into the same site as the botulinum toxin group. The surface EMG activities at maximum voluntary contraction of masseter and anterior temporal muscles were recorded before, 1 week, 2 weeks, and 3 weeks after injection. Presence of jaw functional limitations in each subject was investigated using Korean version of Jaw Functional Limitation Scale(JFLS) questionnaire. The masseter muscle EMG was gradually decreased in the botulinum toxin group comparing with that of the control group(p<0.001), but the anterior temporal muscle EMG did not show significant changes. There was significant increases in the mastication (p<0.01), and global jaw limitation(p<0.05) subscales of JFLS at 1 week after injection, but no significant changes in the other subscales including opening, and verbal and emotional expression during the recording periods. Our results suggest that botulinum toxin injection into masseter muscle can affect modest limitation in mastication function at 1 week after injection but recovered to the baseline until 3 weeks after injection. The EMG activity of masseter muscle had been gradually decreased until 3 weeks after botulinum toxin injection but the anterior temporal muscle did not show any significant changes.

• Journal of the korean veterinary medical association
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• v.48 no.5
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• pp.300-302
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• 2012

• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.325-331
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• 2013

Botulinum neurotoxin(BoNT) is a protease exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from cholinergic nerve endings causing inactivity of muscles or glands. Recently, the therapeutic use of BoNT have expanded to include a wide range of medical and dental conditions. Botulinum neurotoxin type A(BoNT/A) is used off-label in the orofacial region to treat primary and secondary masticatory and facial muscle spasm, severe bruxism, facial tics, orofacial dyskinesias, dystonias, and hypertrophy of the masticatory muscles. Local hematoma, infection, and persistent pain in the injection site are the site-of-injection side effects. Medication-related side effects are adjacent muscle weakness, slurred speech, an alteration in the character of the saliva, and severe headaches. In most cases, these complications are not persistent and bothersome. We reported a case report of a patient who had transient anterior open bite after BoNT/A injection on masseter muscles to treat the refractory myofascial pain.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.1
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• pp.295-301
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• 2017

Botulinum neurotoxin (BoNT/A) is a neurotoxin that selectively attacks the peripheral cholinergic nerve endings. It is produced by Gram -positive, endospore-forming strict anaerobic bacteria, Clostridium botulinum. Since BoNT/A could be a biothreat agent, as well as a contaminator of food and water supplies, the development of sensitive assays for toxin detection and potent antitoxin for the treatment of intoxication is necessary. In this study, for the purpose of producing monoclonal antibodies (mAbs) that are capable of neutralizing Botulinum neurotoxin type A (BoNT/A), scFv (single-chain variable domain fragment) libraries from the rabbit antisera against BoNT/A was fused to a human IgG. The resulting recombinant scFvIgG antibody protein was expressed in stable cell lines and was purified using a protein A affinity chromatography. The efficacy of scFvIgG mAb was confirmed by ELISA and was evaluated for the neutralization of BoNT/A in vivo. Such an in vivo toxin neutralization assay was performed using mice. Although scFvIgG antibody proteins (10 ug) failed to fully protect the mice challenged with BoNT/A (100,000 $LD_{50}$), it significantly prolonged the survival time. These results suggest that scFvIgG mAb may be capable of neutralizing BoNT/A single-chain variable domain fragment.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.2
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• pp.104-110
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• 2012

The usages of botulinum toxin were most commonly for the treatment of spasmodic dysphonia in the otolaryngology field. It has been not only widely used in otolaryngology-Head Neck surgery but also plastic surgery, ophthalmology, rehabilitation medicine, and orthopedics. Now botulinum toxin is used such as blepharospasm (excessive blinking), strabismus, cosmetic, muscle spasms, upper motor neuron syndrome, severe primary axillary hyperhidrosis (excessive sweating), cervical dystonia (spasmodic torticollis), chronic migraine, bruxism, and achalasia. The indication of this drug still gradually expanding with the times. In this articles, the author will demontrate how to use the botulinum toxin for treating cricopharyngeal spasm, arytenoid dislocation, sialocele, Frey syndrome, contact granuloma, bilateral vocal fold paralysis, and mutaional falsetto instead of conventional surgical treatment.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.2
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• pp.185-187
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• 2000

The etiology of vocal fold granuloma was identified : post-endotracheal intubation, vocal abuse, acid reflux and idiopathic. The identification of the cause or causal factor is important, since the treatment must be fundamental directed at them. Treatment have included voice therapy and antireflux measures. Surgical excision is considered in patients who do not respond to medical management. In this study, a case of vocal fold granuloma resolved who underwent injection of the affected vocal fold. Botulinum toxin type A is probably successful by decreasing the strength during adduction in the arytenoid region which, when very intense, would perpetuate the granuloma. Localized injection of this neurotoxin is promising both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy.