Botulinum toxin injection method for oromandibular dystonia applying surgical template

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K09370
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Neurology
• Research Institution: Department of Clinical Research, National Hospital Organization Kyoto Medical Center
• Principal Investigator: Yoshida Kazuya 独立行政法人国立病院機構(京都医療センター臨床研究センター), 臨床研究企画運営部, 研究員 (90263087)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: ボツリヌス治療 / 開口ジストニア / 外側翼突筋 / サージカルテンプレート / CAD/CAM / 顎口腔ジストニア / ボツリヌス毒素

Outline of Final Research Achievements

The subjects were 17 patients with jaw opening dystonia which produces an involuntary opening. The scan data of the upper jaw model and CT data were superimposed on a computer, and the tip of the injection needle was designed to be the most ideal position in the lateral pterygoid muscle, and a guide for insertion was fabricated. The guide was placed in the patient's mouth, the needle was inserted into the sleeve, monitored by electromyography, subsequently 25-50 units of botulinum toxin were injected. Botulinum toxin therapy was performed 31 times without a guide and 30 times with a guide. Insertion of the needle was very easy and there were no complications. The use of guides (63.0%) increased the degree of improvement significantly (P <0.002) more than without guides (54.1%). The method is useful for accurate injection into the lateral pterygoid muscle.

Free Research Field

口腔外科

Academic Significance and Societal Importance of the Research Achievements

顎口腔領域のジストニアは診断や治療が適切に行われないことが多い。診断されたとしても、外側翼突筋へのボツリヌス毒素注射は困難であり、的確に注射できなければ、効果がないばかりか出血や血腫などの副作用を伴う。本研究で開発した方法はインプラント治療の分析のためのソフトを応用し、外側翼突筋内に確実に注射針を刺入できるガイドを作製する方法である。本法を使えば、外側翼突筋への注射の経験がない医師でも、安全で確実に注射ができる。ガイドは滅菌して繰り返し使用が可能であり、臨床的な意義があると考える。