The botulinum toxin was first identified in the late 19th century(1). With its 40 different
subtype this toxin is produced mainly by the gram positive anaerobic bacteria Clostridium
Botulinum(2). This neurotoxin has great affinity to the neuro muscular junction preventing
neurotransmitter release in the synaptic space of acetylcholine(3). The first clinical use
was reported by Alan Scott in 1980(4). The most commonly used subtype is toxin A commercially
found as BOTOX (onabotulinumtoxinA, Allergan, approved by FDA in 1989), Dysport
(abobotulinumtoxinA, Medicis, approved by FDA in 2009) and Xeomin (incobotulinumtoxinA, Merz,
approved by FDA in 2010). As for other commercial toxins botulinum neurotoxin serotype B
product (MYOBLOC™). Neurotoxin Blast generally 12-15 weeks compared to 3-6 month for
neurotoxin A. the FDA approved its use for strabismus in 1989(5), blepharospasm and
hemifacial spasm in 1990(6,7), cervical dystonia in 2000(8), glabella in 2000, hyperhidrosis
in 2004(9), chronic migrane and detrusor overactiviy in 2014. Other off-label uses have
emerged like lanyngeal dysponia, chronic pain etc… (10). Multiple studies with a reduced
number of patients have aimed to quantify the effect of botulinum toxin on brow higth. Some
studies used injections only to the lateral part of the orbicularis,while others added a
corrugator injection. We aimed in this study to compare a known techniques in brow lifting
and associanting that with 2 frontalis injection techniques. The main objective is to
evaluate the shape of the brow and the elevation in multiple brow landmarks before and after
the injection and to see if the frontalis botulinum bloc causes brow ptosis
Phase:
Phase 4
Details
Lead Sponsor:
St Joseph University, Beirut, Lebanon
Treatments:
abobotulinumtoxinA Botulinum Toxins Botulinum Toxins, Type A incobotulinumtoxinA onabotulinumtoxinA