Global Pediatrics (Jun 2023)
Botulinum toxin to reduce cleft lip/palate scars after surgery and improves scar quality in children: A systematic review and meta-analysis
Abstract
Background and objective: Today's culture places a great value on looks and physical features due to social media and visual art. Cleft lip/palate is the most common craniofacial deformity. Even the most skilled surgeon risks being undone by an unattractive scar left behind after cleft correction. Cheiloplasty is the gold standard treatment, and it has a good functional outcome. However, is the most common aftereffect, and its existence may necessitate additional surgical intervention in some patients. Botulinum toxin A is thought to improve scar quality by minimizing wound. Methods: This review was conducted according to the Preferred Reporting Item for Systematic Review and Meta-analyses guidelines. The PubMed, EMBASE, The Cochrane library and the web of science were searched using specifically related key words. Results: In three randomized trials, 109 patients from Mexico, China, and India participated. 2014–2021: Years of study. We compared 55 BTA scars to 54 placebo scars. All three trials had 3–6-month follow-up and had VSS, breadth, and VAS scores. Two trials indicated mean ages of 4.821±47 and 3.170±25 months. In two trials, participants got BTXA after surgery. One trial reported pre-op injections. BTA patients had lower VSS scores than controls at 3 months. 55 experimental patients and 54 control cases were included in the VSS meta-analysis. Overall treatment improved in the BTXA group but not statistically. The difference in breadth scores between the BTA and control groups was statistically significant (p=0.017). Using width scores at second time point, two trials contained 44 experimental and 43 control instances. The mean difference in width ratings between BTA and control groups was not statistically significant while VAS scores between the two groups was significant. Conclusion: BTXA can improve resultant corrective surgical scarring for children with CL/P with minimal to no complications, however, further larger studies are required.
