Montpellier University Hospital, France
Dominique Batifol graduated in 1986 as a Medical Doctor, specialized in maxillo-facial surgery and oral surgery at the University of Montpellier, France. She worked in private practice until 2002 and since then she has been working in the Department of Maxillo-Facial Surgery at the University Hospital of Montpellier (France), working exclusively on Botulinum toxin injections. She has 12 publications in her name.
Initiated in the author’s department in 2007, a prospective study on the usefulness of Botulinum Toxin (BT) in the treatment of algid dysfunction of the temporo-mandibular joint is still ongoing today. Results of treatment usually attempted in this form of pathology, excluding surgery were confronted. Following the work of Mahowald et al., it was decided to inject 30 U Botox* (Allergan Pharmaceuticals, Westport, Ireland) in each articulation using the standard aseptic technique under local anesthesia. Comparison with placebo was not done, knowing that buffered saline has a therapeutic effect. It was chosen to correlate with physiotherapy, medications, dental groove, intra-muscular injections of botulinum toxin and intra-articular injections of hyaluronic acid. Release or decrease of pain was the only goal of the injection. It was measured by visual analogical scale (VAS). For inclusion pain must be greater than 5/10, with all other treatments, excluding surgery, failing to provide any improvement. Currently, there are 56 patients in the study. VAS: 0/10 at one month in 26 patients (46%), some of them presenting a VAS = 10/10 prior to injection. VAS between 2 and 4/10 in 17 patients (30%). 13 patients (24%) showing no quantifiable improvement. Mechanism of BT action on pain has been studied for over ten years. BT seems to block the transmission of pain information. It is well tolerated, with reasonable costs and an easy technique. The action is merely analgesic. The results are encouraging, but must be confirmed by a multi-center randomized study.
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