The effect of botulinum toxin in the masticatory and constrictor musculature of the pharynx as an option in the treatment of obstructive sleep apnea: a case report.

The botulinum toxin (BT) is US Food and Drug Administration-approved for therapeutic applications in different medical conditions. However, BT is not considered an obstructive sleep apnea (OSA) therapy. OSA is characterized by recurrent airway collapse during sleep, leading to intermittent hypoxia, hypercapnia, and arousal. The application of BT in pharyngeal and masticatory musculature can reduce its constrictive activity, attenuating the obstructions. We present the first case report of a 38-year-old man with severe OSA syndrome who underwent a BT infiltration in palatoglossal, stylohyoid, and masseter muscles bilaterally to treat OSA itself. He had significant clinical and polysomnographic improvement during the muscle afferent block by intramuscular injection of BT, without adverse effects.