A CLINICAL COMPARISON OF EMLA CREAM AND VIBRATORY ANESTHETIC DEVICE APPLICATION FOR ALLEVIATION OF PAIN ASSOCIATED WITH BOTULINUM TOXIN INJECTION FOR THE MASSETER MUSCLE HYPERTROPHY
1Başkent Üniversitesi, İstanbul Hastanesi, KBB Bölümü, İstanbul, Turkey Aim: Botulinum toxin injection (BTX-A) for the masseter muscle hypertrophy is a commonly used intervention for cosmetic and bruxism-related purposes. Achieving pain-free injection is important for patient comfort and satisfaction. Aim of this study was to compare the efficiacy of Vibratory Anesthetic Device (VAD) versus Eutectic Mixture of Local Anesthetics (EMLA) cream in alleviation of pain during BTX-A injection for masseter muscle hypertrophy.Methods: Eight-teen patients were injected on both sides. Study was designed as a split-face right-left, self-controlled study: one side pain-alleviation was assured with EMLA application 45 minutes before injection whereas the contralateral side VAD application was used. Patients were asked to rate their injection-related pain based on Visual Analogue Scale (VAS)(0:Minimum 10:Maximum). Patients were also asked to rate each side in comparison to the other side and about the preferred method of injection for the next session.
Results: Mean VAS Score for EMLA-applied side was 3,3±2,5 whereas VAD-applied side was 3,6±2,0. Statistical analysis of VAS Scores revealed no significant difference (p=0.696). Eight out of 18 patients reported less pain on VAD side (44%). Six patients reported less pain on EMLA-applied side (39%), whereas three patients reported no difference between two methods (17%). Statistical analysis on preference revealed no significant difference between two methods (p=0.743). Preferred method for next injection was VAD for 11/18 patients (61%), whereas 7/18 patients preferred EMLA (39%) for next injection. Three patients who reported no difference between two methods preferred VAD for next session due to absence of 45 minute waiting interval before injection.
Conclusions: VAD seems to be a viable method to achieve pain-free injections in comparison to EMLA application. VAD has advantages timewise, costwise and absence of possible side effects.
Keywords : Masseter hypertrophy, botulinum toxin, EMLA, vibratory anesthetic device