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Botulinum Toxin A for Neuropathic Pain After Neck Dissection: A Dose‐Finding Study
Author(s) -
Wittekindt Claus,
Liu WeiChi,
Preuss Simon F.,
GuntinasLichius Orlando
Publication year - 2006
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/01.mlg.0000217797.05523.75
Subject(s) - medicine , neuropathic pain , adverse effect , quality of life (healthcare) , saline , neck dissection , anesthesia , visual analogue scale , neck pain , surgery , head and neck cancer , dissection (medical) , botulinum toxin , cancer , radiation therapy , alternative medicine , nursing , pathology
Objectives: Botulinum toxin type A (BtxA) has been reported to be feasible in chronic neuropathic pain after neck dissection. The impact of the dose on the outcome has not been investigated yet. Study Design: Twenty‐three patients with neuropathic pain after neck dissection were selected for an open and prospective phase II trial. Methods: In the low‐dose group (n = 13), a concentration of 10 mouse units (MU)/0.1 mL saline and in the high‐dose‐group (n = 10), a concentration of 20 MU/0.1 mL saline were injected subcutaneously. Pain and quality of life were assessed at day 0 and day 28, respectively, by visual analog scales (VAS) and European Organization for Research and Treatment of Cancer (EORTC) quality‐of‐life core and EORTC quality‐of‐life head and neck module questionnaires. Results: Patients in the low‐dose group showed a significant pain reduction (VAS) from 4.3 at day 0 to 3.0 at day 28 ( P < .05). The mean pain VAS values in the high‐dose group did not improve significantly. No serious adverse events were observed. There were trends toward improvement in quality of life in the low‐dose group. Conclusions: BtxA in a low concentration seems to be a useful therapeutic option in chronic neuropathic pain of the neck and shoulder after neck dissection.