Background: In recent years treatment of chronic anal fissure has shifted from surgical to medical. This study compared the ability of two non-surgical treatments-botulinum toxin injections and nitroglycerin ointment-to induce healing in patients with idiopathic anal fissure.
Methods: One hundred adults were assigned randomly to receive treatment with either type A botulinum toxin (30 units Botox or 90 units Dysport) injected into the internal anal sphincter or 0.2 per cent nitroglycerin ointment applied three times daily for 8 weeks.
Results: After 2 months, the fissures were healed in 46 (92 per cent) of 50 patients in the botulinum toxin group and in 35 (70 per cent) of 50 in the nitroglycerin group (P=0.009). Three patients in the botulinum toxin group and 17 in the nitroglycerin group reported adverse effects (P<0.001). Those treated with botulinum toxin had mild incontinence to flatus that lasted 3 weeks after treatment but disappeared spontaneously, whereas nitroglycerin treatment was associated with transient, moderate-to-severe headaches. Nineteen patients who did not have a response to the assigned treatment crossed over to the other therapy.
Conclusion: Although treatment with either topical nitroglycerin or botulinum toxin is effective as an alternative to surgery for patients with chronic anal fissure, botulinum toxin is the more effective option.
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http://dx.doi.org/10.1002/bjs.5514 | DOI Listing |
Tech Coloproctol
January 2025
Royal Glamorgan Hospital, Llantrisant, Wales, UK.
Background: Anal fissure is one of the most painful anal conditions. Various management options are available, including topical nitrites, calcium channel blockers, botulinum toxin injection, and lateral internal sphincterotomy. This study aimed to assess the efficacy and safety of botulinum toxin A (BT) injection for the management of symptomatic chronic anal fissures by conducting a systematic review of the literature and meta-analysis of published randomized controlled trials (RCTs).
View Article and Find Full Text PDFRehabilitacion (Madr)
January 2025
University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey.
Objective: Spasticity developing in the upper extremity in stroke patients causes disability by limiting movement and causing pain. This study investigates the effects of botulinum toxin injections on pain, functionality, spasticity, and range of motion in hemiplegic patients with post-stroke spasticity.
Materials And Methods: The study involved a double-blind, prospective, randomized controlled trial with thirty-one stroke patients aged 35-80 who developed upper extremity spasticity.
Clin Park Relat Disord
June 2024
New York Medical College, Valhalla, NY, USA.
Background: Lower extremity dystonia (LED) is a frequent complication of Parkinson disease (PD). Treatment with botulinum neurotoxinA (BoNTA) over 8 years was retrospectively reviewed.Cases14 patients with LED received an average of 3.
View Article and Find Full Text PDFClin Case Rep
January 2025
Toxicological Research Center, Excellence Center & Department of Clinical Toxicology, School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran.
Botulism symptoms after cosmetic botulinum toxin-A (BTX-A) injections happen very rarely, and it needs careful attention since it can be life-threatening. Hence, it is advised to meticulously check the technique, dose, and authenticity of the BTX-A before injections to reduce the adverse effects.
View Article and Find Full Text PDFCureus
December 2024
General Dentistry, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Excessive gingival display (EGD), commonly known as a gummy smile (GS), is a cosmetic concern that involves exposing a significant area of gum tissue during a smile, rendering it unaesthetic. Gingival exposure greater than 3 mm is deemed aesthetically displeasing and often necessitates treatment to mask the gummy smile. The causes of EGD are multifactorial, including altered passive eruption (APE), hypermobile upper lip (HUL), short lip length, increased vertical maxillary component, gingival hyperplasia, dentoalveolar extrusion, and more.
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