Muscle weakness after repeated injection of botulinum toxin type A evaluated according to bite force measurement of human masseter muscle

Dermatol Surg. 2009 Dec;35(12):1902-6. doi: 10.1111/j.1524-4725.2009.01319.x.

Abstract

Background: Botulinum toxin type A (BTX-A) has been applied successfully to treat masseteric hypertrophy, but it can cause muscle weakness.

Objective: To measure the change in maximum bite force (MBF) after BTX-A injection into the human masseter muscle and to evaluate the influence of a booster (repeated) injection.

Methods: Thirty volunteers completed 18-week follow-up, and MBF was measured. At 18 weeks after the first injection, a booster injection was given to 14 patients, and they were followed up until 18 weeks from the booster injection.

Results: Mean MBF was approximately 20% lower at 2 weeks than before the injection, and it recovered gradually after 4 weeks to return to the preinjection level at 12 weeks. MBF differed significantly between before the injection and at 2, 4, and 8 weeks after the injection (p<.05). In the booster injection group (n=14), MBF was markedly lower at 6 weeks (p<.05), and it recovered gradually in 12 weeks.

Conclusion: MBF was significantly lower after booster injection of BTX-A into the human masseter muscle, but it gradually recovered in a predictable pattern, and the degree of discomfort experienced by the subjects had little effect on normal mastication.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bite Force*
  • Botulinum Toxins, Type A / administration & dosage
  • Botulinum Toxins, Type A / pharmacology*
  • Female
  • Humans
  • Hypertrophy / drug therapy
  • Injections, Intramuscular
  • Male
  • Masseter Muscle / drug effects*
  • Masseter Muscle / pathology
  • Muscle Weakness / chemically induced*
  • Neuromuscular Agents / administration & dosage
  • Neuromuscular Agents / pharmacology*

Substances

  • Neuromuscular Agents
  • Botulinum Toxins, Type A