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- Ensaio Clínico NCT07802639
Treatment for "Asymmetric Crying Facies"
A Randomized, Double-Blind, Controlled Study Evaluating the Efficacy of Botulinum Toxin Type A (Hengli) Injection for LowerLip Asymmetry in Children With Craniofacial Microsomia
This study focuses on children with hemifacial microsomia (HFM), a common congenital craniofacial deformity caused by abnormal development of the first and second branchial arches. Up to 45% of children with HFM have facial nerve dysplasia, most frequently involving the mandibular marginal branch. These children present with asymmetric lower-lip movement called "crooked-mouth smile" during smiling, speaking or crying. Unlike asymmetric crying syndrome, this condition does not resolve spontaneously and may gradually get worse.
"Crooked-mouth smile" results from muscle weakness of the lower lip on the affected side, leading to dynamic perioral muscle imbalance. Static treatment includes botulinum toxin injection, muscle resection, nerve cutting and fascia suspension; dynamic treatment includes muscle transfer procedures. Early intervention is important for children's psychological well-being. Botulinum toxin injection is minimally invasive, safe and reversible, and is regarded as a preferred initial therapy. However, prospective clinical evidence regarding its efficacy, safety and appropriate dosage in this pediatric population remains insufficient. This prospective study aims to explore the safety, effectiveness and optimal dose of botulinum toxin injection for treating "crooked-mouth smile" in children with HFM and mandibular marginal branch dysplasia.
Visão geral do estudo
Status
Intervenção / Tratamento
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Xiaoshuang Guo, M.D.
- Número de telefone: +86 13121234163
- E-mail: gxsinjnu@126.com
Locais de estudo
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Beijing, China
- Recrutamento
- Plastic Surgery Hospital & Chinese Academy Of Medical Sciences
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Contato:
- Xiaoshuang Guo, M.D.
- Número de telefone: 86-13121234163
- E-mail: gxsinjnu@126.com
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Investigador principal:
- Xiaoshuang Guo, M.D.
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- Children under 18 years old diagnosed with hemifacial microsomia (HFM) and lower-lip asymmetry, with congenital injury of the marginal mandibular branch of the facial nerve, presenting with lower-lip movement disorder and lower-lip asymmetry during smiling and teeth-baring.
- Subjects who are able to comply with study protocols and visit schedules.
- Subjects whose guardians provide voluntary written informed consent.
Exclusion Criteria:
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Any disease affecting neuromuscular function, including but not limited to neuromuscular junction disorders such as myasthenia gravis and Lambert-Eaton syndrome, peripheral motor nerve diseases such as amyotrophic lateral sclerosis, or a past medical history of the above-mentioned diseases.
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Receiving treatment with any of the following medications:
- Within 4 weeks prior to screening: muscle relaxants (tubocurarine chloride, dantrolene sodium, baclofen, etc.), aminoglycosides, polypeptide antibiotics, spectinomycin hydrochloride, tetracyclines, lincomycin, anticholinergic agents (butylscopolamine bromide, trihexyphenidyl hydrochloride, etc.), benzodiazepines, and other drugs that may inhibit neuromuscular transmission or interfere with the effect of botulinum toxin.
- Anticoagulants or anti-platelet agents used within 7 days before study drug administration.
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Cutaneous abnormalities at the treatment site, including local infection (e.g., herpes simplex, acne, erysipelas), scars, hypertrophic scars, or keloid predisposition.
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Prior perioral treatment within 1-year interval before this study.
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History of hypersensitivity; known allergy to any component of the investigational or comparator product, or known sensitivity to complex protein components (including botulinum toxin type A, human albumin, gelatin protein, lactose, sodium chloride, or sodium succinate).
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Presence of other comorbidities that render the subject inappropriate for enrollment at the investigator's discretion. Eligibility shall be determined by the investigator.
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Participation in another clinical trial (drug or device-related) at the time of screening, or participation in any other clinical trial within 30 days before screening.
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Subjects unable to communicate or incapable of following study instructions.
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Staff members of the study department or sponsor.
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Subjects considered unsuitable for participation in this study by the investigator.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Dobro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Experimental: Intervention Group
Participants receive botulinum toxin injection immediately after enrollment for correction of crooke |
Injection targets the "depressor labii inferioris" and "depressor anguli oris" for correction of crooked-mouth smile. |
|
Comparador Ativo: Control Group (Delayed Treatment)
articipants do not receive botulinum toxin injection at baseline. After completing 6-month follow-up assessment for primary outcomes, subjects in this group will receive botulinum toxin injection. |
Injection targets the "depressor labii inferioris" and "depressor anguli oris" for correction of crooked-mouth smile. |
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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mouth asymmetry
Prazo: 1、3、6 months
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A coordinate system is established based on the palpebral fissure and nasion. The sagittal distance differences at the hemilabial midpoint and oral commissure point are evaluated under static, broad-smile, and teeth-baring conditions in children |
1、3、6 months
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
satisfaction with lips
Prazo: 1、3、6 months
|
Face-Q: satisfaction with lips. FACE-Q Aesthetics: Satisfaction with Lips scale. Patient-reported satisfaction with lip appearance. Rasch-transformed scores range from 0 to 100; higher scores indicate greater satisfaction (better outcome). |
1、3、6 months
|
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Terzis aesthetic and functional grading system for the depressor muscle
Prazo: 1、3、6 months
|
Investigator-assessed depressor muscle aesthetic and functional performance using the Terzis aesthetic and functional grading system for the depressor muscle. Scores range from 0 (Poor, total paralysis) to 2 (Excellent, normal symmetric lower-lip movement); higher scores indicate better aesthetic and functional outcomes. |
1、3、6 months
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Smile Improvement Score
Prazo: 1、3、6 months
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Investigator-assessed improvement in smile aesthetics using the Smile Improvement Score (SIS), a subjective grading system for lip posture during smile. Frontal smile photographs are compared with baseline; scores range from 0(no improvement) to 3 (excellent improvement, symmetric smile); higher scores indicate better smile outcome. |
1、3、6 months
|
Colaboradores e Investigadores
Patrocinador
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
- Doenças ósseas
- Doenças musculoesqueléticas
- Doenças bucais
- Doenças estomatognáticas
- Doenças do Sistema Nervoso
- Infecções
- Doenças Virais
- Infecções por vírus de DNA
- Anormalidades Craniofaciais
- Anormalidades musculoesqueléticas
- Anomalias congénitas
- Infecções Herpesviridae
- Doenças do Nervo Craniano
- Doenças Ósseas do Desenvolvimento
- Doenças do Nervo Facial
- Disostoses
- Disostose Craniofacial
- Disostose Mandibulofacial
- Doenças e Anormalidades Congênitas, Hereditárias e Neonatais
- Paralisia de Bell
- Síndrome de Goldenhar
Outros números de identificação do estudo
- 2024(170)
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
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