top of page

An evidence-based review of botulinum toxin (Botox) applications

Updated: Sep 27, 2023

In non-cosmetic head and neck conditions

Ricardo Persaud, George Garas, [...], and Kalpesh Patel


Botulinum toxin (Botox) is an exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles or glands innervated. Botox is best known for its beneficial role in facial aesthetics but recent literature has highlighted its usage in multiple non-cosmetic medical and surgical conditions. This article reviews the current evidence pertaining to Botox use in the head and neck. A literature review was conducted using The Cochrane Controlled Trials Register, Medline and EMBASE databases limited to English Language articles published from 1980 to 2012. The findings suggest that there is level 1 evidence supporting the efficacy of Botox in the treatment of spasmodic dysphonia, essential voice tremor, headache, cervical dystonia, masticatory myalgia, sialorrhoea, temporomandibular joint disorders, bruxism, blepharospasm, hemifacial spasm and rhinitis. For chronic neck pain there is level 1 evidence to show that Botox is ineffective. Level 2 evidence exists for vocal tics, trigeminal neuralgia, dysphagia and post-laryngectomy oesophageal speech. For stuttering, ‘first bite syndrome’, facial nerve paresis, Frey's syndrome, oromandibular dystonia and palatal/stapedial myoclonus the evidence is level 4. Thus, the literature highlights a therapeutic role for Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence). With ongoing research, the spectrum of clinical applications and number of people receiving Botox will no doubt increase. Botox appears to justify its title as ‘the poison that heals’.


Botulinum toxin (Botox) is a protease exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from cholinergic nerve endings causing inactivity of muscles or glands. Its effects are transient and may be graded by varying the dose and frequency of administration. Botox is one of the most potent naturally occurring biological poisons and in the past has been responsible for many accidental deaths prior to its discovery in medicine. Its first medical use was to treat strabismus in 1980. Nine years later, the cosmetic effects of the toxin on wrinkles were noted, but it was only in 2002, following Food and Drug Administration approval, that Botox gained widespread popularity as an alternative to cosmetic surgery.1

Recently, the therapeutic uses of Botox have expanded exponentially to include a wide range of medical and surgical conditions. This has been aided by a greater understanding of its underlying physiology as well as improved efficacy and safety. This review examines the evidence on Botox usage in non-cosmetic conditions of the head and neck.


The Cochrane Controlled Trials Register, Medline and EMBASE databases were searched from 1980 to 2012. The medical subject heading search terms were ‘botox’ and ‘larynx’ or ‘dysphonia’ or ‘dystonia’ or ‘tremor’ or ‘oral’ or ‘myoclonus’ or ‘temporomandibular’ or ‘sialorrhoea’ or ‘bruxism’ or ‘oesophagus’ or ‘dysphagia’ or ‘speech’ or ‘face’ or ‘autonomic nervous system’ or ‘sweating’ or ‘torticollis’ or ‘pain’ or ‘migraine’ or ‘headache’ or ‘myalgia’ or ‘neuralgia’ or ‘nose’ or ‘rhinitis’. A total of 997 English language abstracts were reviewed and 88 relevant articles identified. Further references were obtained through their bibliographies. Evidence levels, based on those suggested by the Oxford Centre for Evidence-Based Medicine (Table 1),2 are shown in the text inside [ ]. The highest level of evidence pertaining to Botox treatment for each of the ENT conditions is presented in Table 2.

Table 1: Levels of evidence based on those suggested by the Oxford Centre for Evidence-Based Medicine
Table 1: Levels of evidence based on those suggested by the Oxford Centre for Evidence-Based Medicine
Courtesy of PMC3591685

Levels of evidence based on those suggested by the Oxford Centre for Evidence-Based Medicine

Table 2: Levels of evidence for the role of Botox in various head and neck conditions
Table 2: Levels of evidence for the role of Botox in various head and neck conditions
Courtesy of PMC3591685

Levels of evidence for the role of Botox in various head and neck conditions

Results and discussion

Laryngeal conditions

Spasmodic dysphonia

Spasmodic dysphonia is due to inappropriate glottic closure or opening due to spasm of intrinsic laryngeal muscles. Symptoms include hoarseness and strangled speech breaks (adductor type) or hypophonia and breathy voice (abductor type).3 A meta-analysis of 30 randomized controlled trials (RCTs) involving Botox therapy in adductor spasmodic dysphonia revealed an improvement to about one standard deviation across the dependent voice-related Quality of Life (QoL) variables studied [1a].4,5 A subsequent RCT also confirmed the beneficial effects of Botox in spasmodic dysphonia with the greatest improvements present in those patients who were most profoundly impaired [1b].6 In addition, a recent prospective study (n = 133) has demonstrated a mean Voice Handicap Index improvement of 9.6% following laryngeal Botox injection in patients with spasmodic dysphonia.7

Essential voice tremor

Essential voice tremor is characterized by rhythmic activation of mainly the intrinsic laryngeal muscles. The voice is affected by breaks in pitch, diminished fluency and arrests. It naturally accompanies the ageing process, but may also occur with spasmodic dysphonia.8 Electromyography (EMG)-guided Botox injection into the thyroarytenoid muscles was shown to have beneficial effect in a RCT (n = 13) [1b],9 in a prospective crossover study (n = 10) [3b]10 and a case report [4].11

Stuttering or stammering

This refers to a disorder of speech-motor control in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words or phrases, with occasional involuntary silent pauses, collectively caused by poor coordination between lingual, labial, laryngeal and respiratory muscles. There is only one case series that has shown that intralaryngeal Botox injection improves fluency in speech therapy failures so its value in treating this disorder is questionable and requires further research [4].12

Vocal tics (Gille de la Tourette syndrome)

Repetitive dyskinetic movements of the laryngeal musculature lead to the production of embarrassing speech known as vocal tics. This is commonly seen in Gille de la Tourette syndrome. There is one RCT showing that Botox injections into the thyroarytenoid muscles is efficacious in reducing the frequency and urge of vocal and motor tics (n = 18) [2b], but the patients did not report an overall benefit from the treatment.1315 Again, further research is mandated to assess the efficacy of Botox for vocal tics.



Numerous multicentre double-blind placebo-controlled trials support the use of Botox as a prophylactic therapy for migraine [1a].1618 The technique involves injections into muscles innervated by the facial or trigeminal nerves (e.g. procerus, corrugator, frontalis, temporalis and suboccipital), specific sites of pain distribution or a combination of both.19 Significant reductions from baseline were observed in patients in the Botox trial arm with regard to headache and migraine days, cumulative hours of headache and frequency of moderate/severe headache days. A recent meta-analysis confirmed these beneficial effects of Botox but only in the treatment of chronic daily headaches and chronic migraines (>15 episodes per month) [1a]. Adverse effects including blepharoptosis, skin tightness, paraesthesias, neck stiffness, muscle weakness and neck pain can occur at injection sites but these were minimal and transient.20

Cervical dystonia or spasmodic torticollis

This refers to sustained neck muscle contraction resulting in involuntary movements of the head and neck associated with significant cervical pain and abnormal cervical postures. It can be primary or secondary to other neurological disorders.21 The evidence supporting the use of Botox in the treatment of cervical dystonia consists of two Cochrane systematic reviews of 13 (677 participants for Botox A) and three (308 participants for Botox B) high-quality RCTs, respectively [1a].22,23 These meta-analyses showed that single injection of Botox is effective (as evident from both objective and subjective rating scales) and can be safely repeated if necessary. Since then, there have been further RCTs confirming the efficacy and safety of Botox in the treatment of cervical dystonia in both previously treated as well as Botox-naive patients [1b].24 It is worth noting that Botox not only reduces abnormal movements and contractures but can also prevent secondary degenerative changes of the cervical spine and associated radiculopathy.25,26

Masticatory myalgia

Masticatory pain can be explained by chronic nociceptive irritation of the tendons and fascias of the masseter, temporalis and medial pterygoid muscles.27,28 There are three RCTs showing Botox to be more effective than placebo (saline) in reducing masticatory myalgia [1b].2931 The most recent of these three RCTs also evaluated with EMG the action potentials of the masseter and temporalis muscles and showed that these decreased by nearly 80% on day 14, and by 25% on day 28 following Botox injection.30 Botox causes a disuse atrophy of the affected muscle which relieves tension, improves aerobic metabolism and enables decompression of afferent nociceptive neurons through reduction of substance P-mediated neurogenic inflammation.31,32

Chronic neck pain (no benefit with Botox)

Several studies have assessed the role of intramuscular Botox injections in chronic neck pain; however, no significant beneficial effect has been demonstrated. A recent Cochrane systematic review of nine trials (503 participants) showed that Botox alone was no better than the placebo (saline) for patients with subacute or chronic neck pain and concluded that the available evidence does not support the use of Botox either as a monotherapy or in combination with any other treatment in patients with subacute or chronic neck pain [1a].33

Trigeminal neuralgia

The role of Botox in the treatment of drug-refractory trigeminal neuralgia has been evaluated in three studies (n = 15, n = 12, n = 8, respectively).3436 All three studies (including a low-quality RCT) found Botox to be an effective treatment with the majority of the patients reporting a reduction or even disappearance of the pain [2b].3436 Botox was found to be effective in combination with pharmacotherapy, prior to considering more invasive therapies such as surgery or gamma knife radiosurgery.34 As such, Botox is a particularly valuable treatment for elderly patients and those with adverse anaesthetic comorbidities.37,38

First bite syndrome

This is the development of facial pain after the first bite of each meal and is seen after surgery in the parapharyngeal space, especially deep lobe parotidectomy.39 It is probably due to autonomic dysfunction of salivary myoepithelial cells. Intraparotid Botox injection was found to significantly decrease symptom severity and improve the patients’ QoL in a case series of five patients and a case report [4].40,41

Oesophageal conditions

Oesophageal speech post-laryngectomy

Tracheoesophageal puncture in laryngectomy patients allows excellent quality speech development in most cases. The procedure involves cricopharyngeal myotomy and valve placement. However, postoperative pharyngo-oesophageal spasm can cause failure of tracheoesophageal speech and dysphagia.42 Traditionally, this was treated with dilation of the pharyngo-oesophageal segment (POS), pharyngeal myotomy and/or pharyngeal neurectomy.43 More recently, EMG-guided Botox administration that chemically denervates the cricopharyngeus muscle facilitating tracheoesophageal speech and relieving dysphagia has been reported. There are several prospective4447 and retrospective outcomes research studies48 assessing the efficacy of Botox using both subjective (videotaped recordings) and objective (videostroboscopy) outcome measures [2c]. In corroboration, the largest and most recent prospective study consisting of 34 laryngectomized patients showed Botox therapy to be effective in POS voice restoration, especially when combined with speech therapy [2c].44 The effects of Botox were shown to be long-lasting with only one patient needing to be re-injected every three months.44 These results are promising but further, higher quality studies are needed to establish the true value of Botox in oesophageal speech post-laryngectomy.


Incoordination of cricopharyngeal contractions at the initiation of swallowing can result in dysphagia, especially in the elderly population. EMG-guided Botox injections either percutaneously49 or endoscopically50 to the cricopharyngeus muscle were found to be effective in the treatment of dysphagia in a number prospective and retrospective outcomes research studies [2c].5153 Effective toxin administration can predict a successful surgical outcome following cricopharyngeal myotomy.51,54 Again, like with oesophageal speech post-laryngectomy, these results are promising but further, higher quality studies are needed before the true value of Botox in dysphagia is determined.

Oral conditions


Sialorrhoea may occur in neurological and other akinetic disorders such as Parkinson's disease and cerebral palsy. There are several RCTs where the efficacy of Botox injections to the parotid and/or submandibular glands in such patients has been demonstrated [1b].5557 The effects last 3–6 months and can be repeated. Injections can also be used for sialorrhoea caused by salivary fistulas and sialadenitis.58

Temporomandibular joint disorders

Spasm of the lateral pterygoid muscles may cause temporomandibular joint (TMJ) disc displacement anteriorly resulting in exquisite pain and clicking. The evidence supporting the use of Botox in the treatment of such TMJ disorders includes multiple RCTs [1b].29,31,59 However, injection of Botox into the lateral pterygoid muscle may cause a ‘fixed’ smile due to diffusion into the superficial facial muscles.60


This is characterized by non-functional contact of the mandibular and maxillary teeth resulting in clenching or tooth grinding due to repetitive, unconscious contraction of the masseter and temporalis muscles.61 There is one RCT (n = 30) which has shown Botox to be efficacious in reducing myofascial pain symptoms in bruxers compared with control patients receiving saline placebo injections29 with a second one currently underway [1b].62

Oromandibular dystonia

This disorder is characterized by involuntary, action-induced, tonic or clonic spasms of the masticatory, lingual and pharyngeal musculature. Symptoms include dysphagia, dysarthria, bruxism and tempomandibular joint subluxation. There are case series and case reports [4] showing favourable effects of Botox injections into the lateral pterygoid, anterior belly of digastric, masseter and temporalis muscles.63,64 Thus, further higher quality studies are needed to establish the true role of Botox in the treatment of oromandibular dystonia.

Palatal and stapedius myoclonus

Palatal myoclonus is characterized by involuntary palatal contractions, causing clicking tinnitus due to the action of soft palate muscles on the membranous Eustachian tube. Similarly, stapedius myoclonus can cause clicking tinnitus due to the contractions of the stapedius muscle. There are two case reports, one for each type of myoclonus where the use of Botox has been shown to be beneficial in relieving the patients’ symptoms [4]. For palatal myoclonus, Botox was injected in the soft palate under EMG guidance,65 while for stapedius myoclonus, Botox was placed trans-tympanically into the middle ear on a piece of gelfoam.66 In the latter case, the beneficial effects of Botox lasted for four months.

Facial conditions


Involuntary contraction of the eyelid muscles typically occurs bilaterally and in patients over 60 years. The orbicularis oculi muscle is most commonly implicated, but upper facial muscles can also be affected. The therapeutic use of Botox in blepharospasm was first described in 198567 and it has since become the treatment of choice.68 There are three RCTs demonstrating the superiority of Botox over placebo [1b].6971 A recent Cochrane systematic review has concluded that doing more RCTs to prove the effectiveness of Botox over the placebo (saline) would be unethical due to the high efficacy and obvious benefits of Botox in treating blepharospasm.72

Hemifacial spasm

This is characterized by unilateral, recurrent, involuntary movements of the muscles innervated by the facial nerve. It is usually due to compression of the facial nerve near its origin by an aberrant branch of the posterior inferior cerebellar artery.73 The first study to assess Botox in hemifacial spasm was in 1986.74 Since then, there have been several studies, including one RCT which showed Botox to be an effective and safe treatment.75 This RCT involved 11 patients and clearly demonstrated the beneficial effect of the Botox over the placebo [1b].

Facial nerve paresis

Botox may be used to induce therapeutic ptosis, thereby protecting the cornea during the acute phase of facial nerve paresis. This is achieved by transcutaneous injection into Mueller's muscle and the levator palpebrae superioris. There are two case series of therapeutic chemodenervation with Botox of these muscles comprising three and 10 patients, respectively.76,77 Both showed that Botox administration is beneficial in preventing damage as well as healing of the cornea [4]. In addition, there is one case series of 30 patients showing Botox to reduce synkinesis in aberrant facial nerve regeneration following facial nerve paresis.78 In that study, Botox was injected to several synkinetic muscles of patients with facial nerve paresis and all 30 patients experienced improvement after treatment [4].

Nasal conditions


In a RCT of 39 patients with allergic rhinitis, Botox therapy provided better symptomatic control than steroid injections into each inferior turbinate, both in terms of the duration and degree of symptoms [1b].79 In another RCT of 20 patients with idiopathic (vasomotor) rhinitis, topical application of Botox on a sponge significantly reduced rhinorrhoea compared with placebo (saline) but nasal congestion remained unchanged.80 Furthermore, in a study of 38 patients with idiopathic rhinitis, Botox displayed a similar degree and duration of efficacy with regard to hypersecretion symptoms to ipratropium bromide.81 Middle and inferior turbinate injections of Botox were shown to be a highly effective, safe and simple intervention in a RCT of 30 patients with vasomotor rhinitis [1b].82 Hence, the role of Botox seems promising in the treatment of allergic and idiopathic rhinitis though several limiting factors prevent its widespread use. These include the mode of administration which can be associated with the requirement of specialized skills and the potential for significant pain (particularly with injection to the inferior and/or middle turbinates) in addition to its high cost.83

Autonomic conditions

Frey's syndrome

This typically occurs after parotid surgery and is caused by aberrant regeneration of postganglionic parasympathetic fibres innervating sympathetic cholinergic sweat glands. The result is sweating, flushing and piloerection while eating (gustatory sweating).84 Several case series have demonstrated the efficacy of Botox in Frey's syndrome [4].8590 The procedure involves injecting the areas of gustatory sweating identified by an iodine-starch test. Further research is needed to assess the efficacy of Botox as a treatment for Frey's syndrome.


The literature highlights a therapeutic role for Botox in a wide range of non-cosmetic conditions pertaining to Otorhinolaryngology and Head & Neck Surgery. With ongoing research, the spectrum of clinical applications and number of people receiving Botox will no doubt increase. Botox appears to justify its title as ‘the poison that heals’.


Competing interests

None declared


None declared

Ethical approval

Not applicable




RP and GG conceived the idea and wrote the initial draft of the paper after reviewing most of the relevant literature. SS, CS and PC also reviewed some of the relevant literature and contributed to the manuscript as well as editing various drafts. KP had access to the data, reviewed and corrected the manuscript prior to submission


Nektarios Mazarakis and Shahab Khan

Article information

JRSM Short Rep. 2013 Feb; 4(2): 10.

Published online 2013 Feb 12. doi: 10.1177/2042533312472115

PMCID: PMC3591685

PMID: 23476731

1Department of Otorhinolaryngology and Head & Neck Surgery, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK

2Department of Otorhinolaryngology and Head & Neck Surgery, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK

3Department of Otorhinolaryngology and Head & Neck Surgery, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Essex, UK

Correspondence to: Dr George Garas. Email: moc.liamg@2saragegroeg

Copyright © 2013 The Author(s)

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License (, which permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly cited.

Articles from JRSM Short Reports are provided here courtesy of Royal Society of Medicine Press


1. Lang A History and uses of botox (botulinum toxin type a). Lippincotts Case Manag 2004;9:109–12 [PubMed] [Google Scholar]

2. Levels of Evidence published by the Centre for Evidence-Based Medicine, University of Oxford in March 2009. The full reference is available in the following website:

3. Rosenfield DB, Donovan DT, Sulek M, Viswanath NS, Inbody GP, Nudelman HB Neurologic aspects of spasmodic dysphonia. J Otolaryngol 1990;19:231–6 [PubMed] [Google Scholar]

4. Boutsen F, Cannito MP, Taylor M, Bender B Botox treatment in adductor spasmodic dysphonia: a meta-analysis. J Speech Lang Hear Res 2002;45:469–81 [PubMed] [Google Scholar]

5. Brazeau GA Is there time for student intellectual development and scholarly pursuits? Am J Pharm Educ 2010;74:18. [PMC free article] [PubMed] [Google Scholar]

6. Cannito MP, Woodson GE, Murry T, Bender B Perceptual analyses of spasmodic dysphonia before and after treatment. Arch Otolaryngol Head Neck Surg 2004;130:1393–9 [PubMed] [Google Scholar]

7. Novakovic D, Waters HH, D'Elia JB, Blitzer A Botulinum toxin treatment of adductor spasmodic dysphonia: longitudinal functional outcomes. Laryngoscope 2011;121:606–12 [PubMed] [Google Scholar]

8. Wolraich D, Vasile Marchis-Crisan C, Redding N, Khella SL, Mirza N Laryngeal tremor: co-occurrence with other movement disorders. ORL J Otorhinolaryngol Relat Spec 2010;72:291–4 [PubMed] [Google Scholar]

9. Adler CH, Bansberg SF, Hentz JG, et al. Botulinum toxin type a for treating voice tremor. Arch Neurol 2004;61:1416–20 [PubMed] [Google Scholar]

10. Warrick P, Dromey C, Irish JC, Durkin L, Pakiam A, Lang A Botulinum toxin for essential tremor of the voice with multiple anatomical sites of tremor: a crossover design study of unilateral versus bilateral injection. Laryngoscope 2000;110:1366–74 [PubMed] [Google Scholar]

11. Barkmeier-Kraemer J, Lato A, Wiley K Development of a speech treatment program for a client with essential vocal tremor. Semin Speech Lang 2011;32:43–57 [PubMed] [Google Scholar]

12. Brin MF, Stewart C, Blitzer A, Diamond B Laryngeal botulinum toxin injections for disabling stuttering in adults. Neurology 1994;44:2262–6 [PubMed] [Google Scholar]

13. Kwak CH, Hanna PA, Jankovic J Botulinum toxin in the treatment of tics. Arch Neurol 2000;57:1190–3 [PubMed] [Google Scholar]

14. Marras C, Andrews D, Sime E, Lang AE Botulinum toxin for simple motor tics: a randomized, double-blind, controlled clinical trial. Neurology 2001;56:605–10 [PubMed] [Google Scholar]

15. Porta M, Maggioni G, Ottaviani F, Schindler A Treatment of phonic tics in patients with Tourette's syndrome using botulinum toxin type a. Neurol Sci 2004;24:420–3 [PubMed] [Google Scholar]

16. Aurora SK, Dodick DW, Turkel CC, et al. Onabotulinumtoxina for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the preempt 1 trial. Cephalalgia 2010;30:793–803 [PubMed] [Google Scholar]

17. Diener HC, Dodick DW, Aurora SK, et al. Onabotulinumtoxina for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the preempt 2 trial. Cephalalgia 2010;30:804–14 [PubMed] [Google Scholar]

18. Dodick DW, Turkel CC, DeGryse RE, et al. Onabotulinumtoxina for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the preempt clinical program. Headache 2010;50:921–36 [PubMed] [Google Scholar]

19. Durham PL, Cady R Insights into the mechanism of onabotulinumtoxina in chronic migraine. Headache 2011;51:1573–7 [PMC free article] [PubMed] [Google Scholar]

20. Jackson JL, Kuriyama A, Hayashino Y Botulinum toxin a for prophylactic treatment of migraine and tension headaches in adults: a meta-analysis. JAMA 2012;307:1736–45 [PubMed] [Google Scholar]

21. Velickovic M, Benabou R, Brin MF Cervical dystonia pathophysiology and treatment options. Drugs 2001;61:1921–43 [PubMed] [Google Scholar]

22. Costa J, Espirito-Santo C, Borges A, et al. Botulinum toxin type a therapy for cervical dystonia. Cochrane Database Syst Rev 2005;1:CD003633. [PubMed] [Google Scholar]

23. Costa J, Espirito-Santo C, Borges A, et al. Botulinum toxin type b for cervical dystonia. Cochrane Database Syst Rev 2005;1:CD004315. [PubMed] [Google Scholar]

24. Comella CL, Jankovic J, Truong DD, Hanschmann A, Grafe S Efficacy and safety of incobotulinumtoxina (nt 201, xeomin(r), botulinum neurotoxin type a, without accessory proteins) in patients with cervical dystonia. J Neurol Sci 2011;308:103–9 [PubMed] [Google Scholar]

25. Jankovic J Botulinum toxin therapy for cervical dystonia. Neurotox Res 2006;9:145–8 [PubMed] [Google Scholar]

26. Ruiz PJ, Castrillo JC, Burguera JA, et al. Evolution of dose and response to botulinum toxin a in cervical dystonia: a multicenter study. J Neurol 2011;258:1055–7 [PubMed] [Google Scholar]

27. Clark GT Classification, causation and treatment of masticatory myogenous pain and dysfunction. Oral Maxillofac Surg Clin North Am 2008;20:145–57, v [PubMed] [Google Scholar]

28. Solberg WK Temporomandibular disorders: masticatory myalgia and its management. Br Dent J 1986;160:351–6 [PubMed] [Google Scholar]

29. Guarda-Nardini L, Manfredini D, Salamone M, Salmaso L, Tonello S, Ferronato G Efficacy of botulinum toxin in treating myofascial pain in bruxers: a controlled placebo pilot study. Cranio 2008;26:126–35 [PubMed] [Google Scholar]

30. Kurtoglu C, Gur OH, Kurkcu M, Sertdemir Y, Guler-Uysal F, Uysal H Effect of botulinum toxin-a in myofascial pain patients with or without functional disc displacement. J Oral Maxillofac Surg 2008;66:1644–51 [PubMed] [Google Scholar]

31. von Lindern JJ, Niederhagen B, Berge S, Appel T Type a botulinum toxin in the treatment of chronic facial pain associated with masticatory hyperactivity. J Oral Maxillofac Surg 2003;61:774–8 [PubMed] [Google Scholar]

32. Bhogal PS, Hutton A, Monaghan A A review of the current uses of botox for dentally-related procedures. Dent Update 2006;33:165–8 [PubMed] [Google Scholar]

33. Langevin P, Peloso PM, Lowcock J, et al. Botulinum toxin for subacute/chronic neck pain. Cochrane Database Syst Rev 2011;7:CD008626. [PubMed] [Google Scholar]

34. Bohluli B, Motamedi MH, Bagheri SC, et al. Use of botulinum toxin a for drug-refractory trigeminal neuralgia: preliminary report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:47–50 [PubMed] [Google Scholar]

35. Turk U, Ilhan S, Alp R, Sur H Botulinum toxin and intractable trigeminal neuralgia. Clin Neuropharmacol 2005;28:161–2 [PubMed] [Google Scholar]

36. Zuniga C, Diaz S, Piedimonte F, Micheli F Beneficial effects of botulinum toxin type a in trigeminal neuralgia. Arq Neuropsiquiatr 2008;66:500–3 [PubMed] [Google Scholar]

37. Allam N, Brasil-Neto JP, Brown G, Tomaz C Injections of botulinum toxin type a produce pain alleviation in intractable trigeminal neuralgia. Clin J Pain 2005;21:182–4 [PubMed] [Google Scholar]

38. Ngeow WC, Nair R Injection of botulinum toxin type a (botox) into trigger zone of trigeminal neuralgia as a means to control pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:e47–50 [PubMed] [Google Scholar]

39. Linkov G, Morris LG, Shah JP, Kraus DH First bite syndrome: incidence, risk factors, treatment, and outcomes. Laryngoscope 2012;122:1773–8 [PubMed] [Google Scholar]

40. Ali MJ, Orloff LA, Lustig LR, Eisele DW Botulinum toxin in the treatment of first bite syndrome. Otolaryngol Head Neck Surg 2008;139:742–3 [PubMed] [Google Scholar]

41. Lee BJ, Lee JC, Lee YO, Wang SG, Kim HJ Novel treatment of first bite syndrome using botulinum toxin type a. Head Neck 2009;31:989–93 [PubMed] [Google Scholar]

42. Chao SS, Graham SM, Hoffman HT Management of pharyngoesophageal spasm with botox. Otolaryngol Clin North Am 2004;37:559–66 [PubMed] [Google Scholar]

43. Blitzer A, Komisar A, Baredes S, Brin MF, Stewart C Voice failure after tracheoesophageal puncture: management with botulinum toxin. Otolaryngol Head Neck Surg 1995;113:668–70 [PubMed] [Google Scholar]

44. Bartolomei L, Zambito Marsala S, Pighi GP, et al. Botulinum toxin type a: an effective treatment to restore phonation in laryngectomized patients unable to voice. Neurol Sci 2011;32:443–7 [PubMed] [Google Scholar]

45. Lewin JS, Bishop-Leone JK, Forman AD, Diaz EM Jr Further experience with botox injection for tracheoesophageal speech failure. Head Neck 2001;23:456–60 [PubMed] [Google Scholar]

46. Meleca RJ, Dworkin JP, Zormeier MM, Simpson ML, Shibuya T, Mathog RH Videostroboscopy of the pharyngoesophageal segment in laryngectomy patients treated with botulinum toxin. Otolaryngol Head Neck Surg 2000;123:38–43 [PubMed] [Google Scholar]

47. Zormeier MM, Meleca RJ, Simpson ML, et al. Botulinum toxin injection to improve tracheoesophageal speech after total laryngectomy. Otolaryngol Head Neck Surg 1999;120:314–9 [PubMed] [Google Scholar]

48. Hamaker RC, Blom ED Botulinum neurotoxin for pharyngeal constrictor muscle spasm in tracheoesophageal voice restoration. Laryngoscope 2003;113:1479–82 [PubMed] [Google Scholar]

49. Masiero S, Briani C, Marchese-Ragona R, Giacometti P, Costantini M, Zaninotto G Successful treatment of long-standing post-stroke dysphagia with botulinum toxin and rehabilitation. J Rehabil Med 2006;38:201–3 [PubMed] [Google Scholar]

50. Parameswaran MS, Soliman AM Endoscopic botulinum toxin injection for cricopharyngeal dysphagia. Ann Otol Rhinol Laryngol 2002;111:871–4 [PubMed] [Google Scholar]

51. Ahsan SF, Meleca RJ, Dworkin JP Botulinum toxin injection of the cricopharyngeus muscle for the treatment of dysphagia. Otolaryngol Head Neck Surg 2000;122:691–5 [PubMed] [Google Scholar]

52. Moerman M, Callier Y, Dick C, Vermeersch H Botulinum toxin for dysphagia due to cricopharyngeal dysfunction. Eur Arch Otorhinolaryngol 2002;259:1–3 [PubMed] [Google Scholar]

53. Murry T, Wasserman T, Carrau RL, Castillo B Injection of botulinum toxin a for the treatment of dysfunction of the upper esophageal sphincter. Am J Otolaryngol 2005;26:157–62 [PubMed] [Google Scholar]

54. Schneider I, Thumfart WF, Pototschnig C, Eckel HE Treatment of dysfunction of the cricopharyngeal muscle with botulinum a toxin: introduction of a new, noninvasive method. Ann Otol Rhinol Laryngol 1994;103:31–5 [PubMed] [Google Scholar]

55. Lagalla G, Millevolte M, Capecci M, Provinciali L, Ceravolo MG Botulinum toxin type a for drooling in Parkinson's disease: a double-blind, randomized, placebo-controlled study. Mov Disord 2006;21:704–7 [PubMed] [Google Scholar]

56. Mancini F, Zangaglia R, Cristina S, et al. Double-blind, placebo-controlled study to evaluate the efficacy and safety of botulinum toxin type a in the treatment of drooling in parkinsonism. Mov Disord 2003;18:685–8 [PubMed] [Google Scholar]

57. Ondo WG, Hunter C, Moore W A double-blind placebo-controlled trial of botulinum toxin b for sialorrhea in Parkinson's disease. Neurology 2004;62:37–40 [PubMed] [Google Scholar]

58. Ellies M, Gottstein U, Rohrbach-Volland S, Arglebe C, Laskawi R Reduction of salivary flow with botulinum toxin: extended report on 33 patients with drooling, salivary fistulas, and sialadenitis. Laryngoscope 2004;114:1856–60 [PubMed] [Google Scholar]

59. Denglehem C, Maes JM, Raoul G, Ferri J [Botulinum toxin a: analgesic treatment for temporomandibular joint disorders]. Rev Stomatol Chir Maxillofac 2012;113:27–31 [PubMed] [Google Scholar]

60. Chikhani L, Dichamp J [Bruxism, temporo-mandibular dysfunction and botulinum toxin]. Ann Readapt Med Phys 2003;46:333–7 [PubMed] [Google Scholar]

61. Behr M, Hahnel S, Faltermeier A, et al. The two main theories on dental bruxism. Ann Anat 2012;194:216–9 [PubMed] [Google Scholar]

62. Song F, Altman DG, Glenny AM, Deeks JJ Validity of indirect comparison for estimating efficacy of competing interventions: empirical evidence from published meta-analyses. BMJ 2003;326:472. [PMC free article] [PubMed] [Google Scholar]

63. Mendes RA, Upton LG Management of dystonia of the lateral pterygoid muscle with botulinum toxin a. Br J Oral Maxillofac Surg 2009;47:481–3 [PubMed] [Google Scholar]

64. Moller E, Bakke M, Dalager T, Werdelin LM Oromandibular dystonia involving the lateral pterygoid muscles: four cases with different complexity. Mov Disord 2007;22:785–90 [PubMed] [Google Scholar]

65. Conill Tobias N, Paula Vernetta CD, Garcia Callejo FJ, Marco Algarra J Objective tinnitus from palatal myoclonus. Use of botulinum toxin: a case report. Acta Otorrinolaringol Esp 2012;63:391–2 [PubMed] [Google Scholar]

66. Liu HB, Fan JP, Lin SZ, Zhao SW, Lin Z Botox transient treatment of tinnitus due to stapedius myoclonus: case report. Clin Neurol Neurosurg 2011;113:57–8 [PubMed] [Google Scholar]

67. Scott AB, Kennedy RA, Stubbs HA Botulinum a toxin injection as a treatment for blepharospasm. Arch Ophthalmol 1985;103:347–50 [PubMed] [Google Scholar]

68. Jankovic J Botulinum a toxin in the treatment of blepharospasm. Adv Neurol 1988;49:467–72 [PubMed] [Google Scholar]

69. Fahn S LT, Moslowitz C, Brin M, Bressman S, Burke R, Scott A Double blind controlled study of botulinum toxin for blepharospasm. Neurology 1985;35(Suppl):271–2 [Google Scholar]

70. Frueh BR, Nelson CC, Kapustiak JF, Musch DC The effect of omitting botulinum toxin from the lower eyelid in blepharospasm treatment. Am J Ophthalmol 1988;106:45–7 [PubMed] [Google Scholar]

71. Jankovic J Blepharospasm and oromandibular-laryngeal-cervical dystonia: a controlled trial of botulinum a toxin therapy. Adv Neurol 1988;50:583–91 [PubMed] [Google Scholar]

72. Costa J, Espirito-Santo C, Borges A, et al. Botulinum toxin type a therapy for blepharospasm. Cochrane Database Syst Rev 2005;1:CD004900. [PubMed] [Google Scholar]

73. Illingworth RD, Porter DG, Jakubowski J Hemifacial spasm: a prospective long-term follow up of 83 cases treated by microvascular decompression at two neurosurgical centres in the United Kingdom. J Neurol Neurosurg Psychiatry 1996;60:72–7 [PMC free article] [PubMed] [Google Scholar]

74. Elston JS Botulinum toxin treatment of hemifacial spasm. J Neurol Neurosurg Psychiatry 1986;49:827–9 [PMC free article] [PubMed] [Google Scholar]

75. Yoshimura DM, Aminoff MJ, Tami TA, Scott AB Treatment of hemifacial spasm with botulinum toxin. Muscle Nerve 1992;15:1045–9 [PubMed] [Google Scholar]

76. Naik MN, Gangopadhyay N, Fernandes M, Murthy R, Honavar SG Anterior chemodenervation of levator palpebrae superioris with botulinum toxin type-a (botox) to induce temporary ptosis for corneal protection. Eye (Lond) 2008;22:1132–6 [PubMed] [Google Scholar]

77. Reddy UP, Woodward JA Abobotulinum toxin a (dysport) and botulinum toxin type a (botox) for purposeful induction of eyelid ptosis. Ophthal Plast Reconstr Surg 2010;26:489–91 [PubMed] [Google Scholar]

78. Toffola ED, Furini F, Redaelli C, Prestifilippo E, Bejor M Evaluation and treatment of synkinesis with botulinum toxin following facial nerve palsy. Disabil Rehabil 2010;32:1414–8 [PubMed] [Google Scholar]

79. Yang TY, Jung YG, Kim YH, Jang TY A comparison of the effects of botulinum toxin a and steroid injection on nasal allergy. Otolaryngol Head Neck Surg 2008;139:367–71 [PubMed] [Google Scholar]

80. Rohrbach S, Junghans K, Kohler S, Laskawi R Minimally invasive application of botulinum toxin a in patients with idiopathic rhinitis. Head Face Med 2009;5:18. [PMC free article] [PubMed] [Google Scholar]

81. Sapci T, Yazici S, Evcimik MF, et al. Investigation of the effects of intranasal botulinum toxin type a and ipratropium bromide nasal spray on nasal hypersecretion in idiopathic rhinitis without eosinophilia. Rhinology 2008;46:45–51 [PubMed] [Google Scholar]

82. Ozcan C, Vayisoglu Y, Dogu O, Gorur K The effect of intranasal injection of botulinum toxin a on the symptoms of vasomotor rhinitis. Am J Otolaryngol 2006;27:314–8 [PubMed] [Google Scholar]

83. Nowak K, Szyfter W [Application of botulinum toxin a in chronic intrinsic rhinitis]. Otolaryngol Pol 2011;65:103–5 [PubMed] [Google Scholar]

84. Neumann A, Rosenberger D, Vorsprach O, Dazert S [The incidence of Frey syndrome following parotidectomy: results of a survey and follow-up]. HNO 2011;59:173–8 [PubMed] [Google Scholar]

85. Beerens AJ, Snow GB Botulinum toxin a in the treatment of patients with Frey syndrome. Br J Surg 2002;89:116–9 [PubMed] [Google Scholar]

86. Cantarella G, Berlusconi A, Mele V, Cogiamanian F, Barbieri S Treatment of Frey's syndrome with botulinum toxin type b. Otolaryngol Head Neck Surg 2010;143:214–8 [PubMed] [Google Scholar]

87. de Bree R, Duyndam JE, Kuik DJ, Leemans CR Repeated botulinum toxin type a injections to treat patients with Frey syndrome. Arch Otolaryngol Head Neck Surg 2009;135:287–90 [PubMed] [Google Scholar]

88. Drobik C, Laskawi R Frey's syndrome: treatment with botulinum toxin. Acta Otolaryngol 1995;115:459–61 [PubMed] [Google Scholar]

89. Pomprasit M, Chintrakarn C Treatment of Frey's syndrome with botulinum toxin. J Med Assoc Thai 2007;90:2397–402 [PubMed] [Google Scholar]

90. Steffen A, Rotter N, Konig IR, Wollenberg B Botulinum toxin for Frey's syndrome: a closer look at different treatment responses. J Laryngol Otol 2012;126:185–9 [PubMed] [Google Scholar]



Obtuvo 0 de 5 estrellas.
Aún no hay calificaciones

Agrega una calificación
bottom of page