Long Term Evaluation of the Effect of Botulinum Toxin A Injection on the Masseteric

교근 비대 환자에서 보툴리눔 A형 독소 주사 효과의 장기적 평가

  • Hong, Hee-Suk (Dept. of Oral Medicine, College of Dentistry, Yonsei University) ;
  • Kang, Seung-Chul (Dept. of Oral Medicine, College of Dentistry, Yonsei University) ;
  • Kim, Chong-Youl (Dept. of Oral Medicine, College of Dentistry, Yonsei University) ;
  • Kim, Seong-Taek (Dept. of Oral Medicine, College of Dentistry, Yonsei University)
  • 홍희숙 (연세대학교 치과대학 구강내과학교실) ;
  • 강승철 (연세대학교 치과대학 구강내과학교실) ;
  • 김종열 (연세대학교 치과대학 구강내과학교실) ;
  • 김성택 (연세대학교 치과대학 구강내과학교실)
  • Published : 2005.03.30

Abstract

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.

실험 대상자는 좌우측 교근에 보툴리눔 A 형 독소를 주입한 후 15개월 간 추적 조사가 시행된 11명이었다. 지원자들은 양측 교근에 보툴리눔 A형 독소를 주입하기 전, 주입 후 3개월, 주입 후 15개월 경과 후 각각 전산화 단층촬영을 시행하여 교근의 위축 정도를 관찰하였다. 측정은 하악골 하연을 기준면으로 하여 이 기준면의 상방 10 mm(position 1), 20 mm(position 2), 40 mm(position 3)의 세 위치에서 각각 두께와 면적을 측정하였다. 자입 지점은 position 1에 가장 근접했다. 먼저 교근의 두께 변화를 살펴보면 술후 3개월에 측정한 교근의 두께는 모든 position에서 감소하였으나 술후 15개월에는 술전과 비교할 때 유의한 두께 감소는 보이지 않았다. 반면에, 술후 3개월에 측정한 교근의 면적은 모든 position에서 감소하였으나 술후 15개월 경과 후에는 독소 주입 위치에서 가까운 position 1, 2에서는 면적 감소를 인정할 수 있었으나(position 1에서 10.7%, position 2에서 4.4%) 상대적으로 먼 position 3 에서는 면적 감소를 보이지 않았다. 이와 같은 연구 결과로 보아 독소 주입 15개월 후에도 약간의 교근 위축 효과가 남아 있는 것으로 판단되며, 위축량의 측정 시 일차원적인 두께 측정보다는 이차원적인 면적 측정이 더 정밀성이 있는 것으로 사료된다.

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