|
Botulinum toxin Type A (BOTOX™) blocks release of neuromediator acetylcholine from presynaptic membrane in the area of myoneural junction, which leads to irreversible but temporary muscles paralysis (weakness).
Contraction of the muscle that raises eyebrows creates horizontal wrinkles on forehead. Contraction of the muscles that cause frown leads to appearance of deep vertical wrinkles in the glabella area. Contraction of the muscle that causes corrugation of nose skin leads to appearance of wrinkles in frontonasal sulcus area.
Contraction of the orbital muscle that causes palpebral fissure squinting / stretching causes development of wrinkles in outer corners of palpebral fissures (so called “crow’s feet”).
Current plastic surgery methods of correction of such wrinkles are both surgical and non-surgical.
Action of botulinum toxin type A leads to development of temporary flaccid paralysis.
Contraindications to botulinum toxin type A are: (a) hypersensitivity to any component of the preparation; (b) generalized movement disorder; (c) intake of aminoglycoside antibiotics or spectinomycin. Safety of the preparation use during pregnancy is not yet proved. Authors consider pregnancy as contraindication to the use of preparation.
Use of botulinum toxin type A to induce temporary muscles paralysis can solve this problem. Procedure of the preparation injection is relatively simple to perform on an outpatient basis and discomforts patient only slightly. Most patients note beginning of muscle weakness during first 72 hours after injection. Sometimes it takes up to one week for paralysis / muscle weakness effect to develop. Exact duration of Botox clinical effect is unknown.
Botox injection is safe, simple and effective method of elimination of excessive activity of mimetic muscles of the upper part of the face that are responsible for forming of wrinkles. Botox also delays forming of intradermal folds and prolongs effect of wrinkles treatment by collagen injections. Easiness of use and absence of aftereffects make Botox a powerful support of plastic surgery in treatment of face ageing.
Botulinum toxin scope
Botulinum toxin can be used in treatment of pathological states listed below. Indications are approved by FDA Administration:
Blepharospasm
Involuntary eyelid closing of various intensity that causes rapid winking, impossibility of eye opening, and even “blindness”, i.e. impossibility of seeing.
Strabismus
Strabismus is a squint caused by imbalance of oculomotorius muscles functioning. Squint causes diplopia and other unpleasant sensations.
Indications that are not yet approved by FDA:
Hemifacial spasm
Stimulation of facial nerve causes involuntary muscles spasm on one side of face.
Facial wrinkles
The toxin can be used in cosmetology for temporary elimination of some types of wrinkles, e.g. vertical skin folds in glabella area (“frowning” wrinkles), that are formed because of excessive activity of frontal muscles.
Stammering
Use of the toxin in stammering treatment is based on the fact that excessive activity of certain muscles contributes in some way to speech disturbance. Some studies have already proved effectiveness of such treatment method. However further research needs to be done in this field.
Stroke
Botulinum toxin can help to reduce spasticity that develops in paralyzed arm or leg. This treatment is effective if it begins before muscle contractures develop in the extremities involved.
Esophageal achalasia
Pathological condition that develops as a result of abnormal relaxation of muscles of the lower part of esophagus and impossibility to push bolus down the esophagus, which is normally achieved by undulating contractions of its walls (this process is called peristalsis).
Scoliosis
Some scientific publications inform that toxin injections help to avoid surgical operations at severe forms of spinal curvature.
Dystonia
This disorder declares itself as involuntary contractions in one or several areas of the body. Dystonia can be generalized or focal (when only one area of the body is involved). For example, dystonia can be in muscles of neck, lower jaw, larynx, arms, or legs. Spasms result in disturbances of phonation and body posture, difficulties in ambulation, etc.
Cerebral palsy
Botulinum toxin injections can facilitate ambulation for some cerebral palsy patients. This disease makes leg movements difficult because of pathological contractions of certain muscle groups. Injection helps to relax muscles involved in spasm and bring their length closer to normal by means of stretching. In case of infantile cerebral palsy such measures can provide certain degree of growth of the affected extremities that is otherwise impossible because of formation of muscle contractures in the extremities.
Rectum fissures
Chronic forms can lead to protracted constipations.
Vaginism
Pathological state that is caused by involuntary spasms of vaginal muscles and can impede coitus. This disorder occurs among women with frequency of 1/200.
Experts place botulinum toxin among the most important medical products intended for treatment of certain types of serious ophthalmic pathology and other diseases of central nervous system. |
