Chemomyectomy of the Orbicularis Oculi Muscles for the Treatment of Localized Hemifacial Spasm

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Title Chemomyectomy of the Orbicularis Oculi Muscles for the Treatment of Localized Hemifacial Spasm
Creator Jonathan D. Wirtschafter, MD
Affiliation Department of Ophthalmology, University of Minnesota Medical School, Minneapolis
Abstract OBJECTIVE: To report our experience with doxorubicin chemomyectomy as an alternative to other treatments for hemifacial spasm (HFS). DESIGN: A prospective, open study Phase I clinical trial of chemomyectomy. SETTING: A hospital-based, referral neuro-ophthalmology and oculoplastic service. PATIENTS AND METHODS: Repeated (1-6, median: 4) local injections of doxorubicin were given in the eyelids of 8 patients (5 men, 3 women, average age: 71). MAIN OUTCOME MEASURES: Eyelid strength, self-reported spasm, and duration of improvement without seeking additional or alternative treatments. RESULTS: Chemomyectomy resulted in permanent (> or = 2.5 years) orbicularis oculi weakness and relief from spasms in the treated areas in 5 patients, although 2 patients requested occasional supplementary botulinum toxin (BT) injections in the facial muscles over the cheek. One patient had a successful result for 3 years, after which spasm recurred. One patient maintains a successful result in the eyelid but had a failed microvascular decompression in the lower face. One incompletely treated patient required microvascular decompression following spread of spasms to the lower branches of the facial nerve and increased severity of the HFS. One patient required eyelid surgery because of concurrent spastic entropion. One patient treated with a higher concentration than currently used required closure of a skin ulcer. CONCLUSIONS: Doxorubicin chemomyectomy is an effective alternative to conventional therapy for properly selected patients affected by HFS, particularly older patients with relatively localized eyelid muscle spasms. The modified technique of doxorubicin chemomyectomy has developed to the point where its safety is demonstrated and its risks are known.
Subject Older people; Older people, 80 and over; Blepharospasm/drug therapy; Doxorubicin/administration & dosage; Doxorubicin/therapeutic use; Eyelids/drug effects; Eyelids/innervation; Facial Muscles; Female; Humans; Male; Middle Older people; Muscle Denervation/methods; Oculomotor Muscles; Prospective Studies; Spasm/drug therapy
OCR Text Show
Date 1994-12
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6z63v33
Setname ehsl_novel_jno
ID 224529
Reference URL https://collections.lib.utah.edu/ark:/87278/s6z63v33
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