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Botulinum toxin type A for the treatment of chronic neck pain after neck dissection
Author(s) -
Vasan Claus Wittekindt,
Liu WeiChi,
Klussmann JensPeter,
GuntinasLichius Orlando
Publication year - 2004
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.10340
Subject(s) - medicine , neck pain , neck dissection , quality of life (healthcare) , botulinum toxin , chronic pain , visual analogue scale , surgery , anesthesia , physical therapy , alternative medicine , nursing , pathology , carcinoma
Background. Neck dissection surgery is often followed by chronic head and neck pain. To date optimal treatment of this type of pain is lacking. Botulinum toxin type A (BTX‐A) has been shown to be effective in the treatment of myofascial pain syndrome and headache. In a pilot study, we wanted to test the effectiveness of BTX‐A for the treatment of chronic neck pain after neck dissection. Methods. Sixteen patients with chronic neck pain after neck dissection were included in this prospective, open study. Eighty to 320 units of BTX‐A (Dysport) were injected into muscular trigger points. Outcome measures included chronic pain and shooting pain on the basis of visual analog scales and quality of life improvement (EORTC QLQ‐C‐30; EORTC QLQ‐H&N35) before and 4 weeks after treatment. Results. Patients showed a significant reduction in chronic pain (4.5 before to 3.3 after treatment, p = ,005) and in shooting pain (6.1 before to 4.7 after treatment, p = .005). There was a trend toward improvement in global quality of life (QLQ‐C30, p = .097) and an increase on the functional scale “pain” (QLQ‐H&N35, p = .071). Conclusions. BTX‐A treatment of subjects with chronic neck pain after neck dissection resulted in a fast and significant reduction of pain. A significant improvement in quality of life may be expected in a longer time course after treatment. © 2004 Wiley Periodicals, Inc. Head Neck 26: 39–45, 2004