• Dana M Hartl, Myriam Cohen, Morbize Juliéron, Patrick Marandas, Franéois Janot, and Jean Bourhis.
• Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France. dana.hartl@igr.fr
• Otolaryngol Head Neck Surg. 2008 Apr 1; 138 (4): 459-463.

ObjectiveTo report the efficacy of botulinum toxin A for radiation-induced pain, trismus, and masticator spasm in head and neck cancer.Patients And MethodsThis prospective nonrandomized study included patients in complete remission with radiation-induced pain and trismus with or without masticator spasms. Fifty units of Botox (Allergan) or 250 units of Dysport (Ipsen) were injected transcutaneously into the masseter muscles. Jaw opening was measured and patients answered 20 questions about jaw opening, pain, and cramps, before injection at 1 month.ResultsNineteen patients (7 women, 12 men) were included. Median time after radiation therapy was 5 years (range, 11 months to 22 years). At 1 month, no significant increase in jaw opening was recorded. Improvement was noted in the functional domain (P = 0.004), for pain (P = 0.002) and cramps (P = 0.004), but not in the social (P = 0.83) or emotional (P = 0.43) domains. No side effects occurred.ConclusionsBotulinum toxin did not improve trismus but significantly improved pain scores and masticator spasms (oromandibular dystonia).

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