{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:51:14Z","timestamp":1791291074496,"version":"4.3.0"},"reference-count":90,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T00:00:00Z","timestamp":1359676800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JRSM Short Reports"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:p>Botulinum toxin (Botox) is an exotoxin produced from Clostridium botulinum. It works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles or glands innervated. Botox is best known for its beneficial role in facial aesthetics but recent literature has highlighted its usage in multiple non-cosmetic medical and surgical conditions. This article reviews the current evidence pertaining to Botox use in the head and neck. A literature review was conducted using The Cochrane Controlled Trials Register, Medline and EMBASE databases limited to English Language articles published from 1980 to 2012. The findings suggest that there is level 1 evidence supporting the efficacy of Botox in the treatment of spasmodic dysphonia, essential voice tremor, headache, cervical dystonia, masticatory myalgia, sialorrhoea, temporomandibular joint disorders, bruxism, blepharospasm, hemifacial spasm and rhinitis. For chronic neck pain there is level 1 evidence to show that Botox is ineffective. Level 2 evidence exists for vocal tics, trigeminal neuralgia, dysphagia and post-laryngectomy oesophageal speech. For stuttering, \u2018first bite syndrome\u2019, facial nerve paresis, Frey's syndrome, oromandibular dystonia and palatal\/stapedial myoclonus the evidence is level 4. Thus, the literature highlights a therapeutic role for Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence). With ongoing research, the spectrum of clinical applications and number of people receiving Botox will no doubt increase. Botox appears to justify its title as \u2018the poison that heals\u2019.<\/jats:p>","DOI":"10.1177\/2042533312472115","type":"journal-article","created":{"date-parts":[[2013,4,12]],"date-time":"2013-04-12T19:36:35Z","timestamp":1365795395000},"page":"1-9","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":77,"title":["An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions"],"prefix":"10.1177","volume":"4","author":[{"given":"Ricardo","family":"Persaud","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head & Neck Surgery, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Garas","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head & Neck Surgery, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjeev","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head & Neck Surgery, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantine","family":"Stamatoglou","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head & Neck Surgery, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Chatrath","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head & Neck Surgery, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Essex, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalpesh","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head & Neck Surgery, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,2,1]]},"reference":[{"key":"bibr1-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1097\/00129234-200403000-00011"},{"key":"bibr2-2042533312472115","volume-title":"Levels of Evidence published by the Centre for Evidence-Based Medicine","year":"2009"},{"key":"bibr3-2042533312472115","first-page":"231","volume":"19","author":"Rosenfield DB","year":"1990","journal-title":"J Otolaryngol"},{"key":"bibr4-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2002\/037)"},{"key":"bibr5-2042533312472115","doi-asserted-by":"publisher","DOI":"10.5688\/aj740218"},{"key":"bibr6-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.12.1393"},{"key":"bibr7-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21395"},{"key":"bibr8-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1159\/000317032"},{"key":"bibr9-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.9.1416"},{"key":"bibr10-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200008000-00028"},{"key":"bibr11-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1271974"},{"key":"bibr12-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.12.2262"},{"key":"bibr13-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.57.8.1190"},{"key":"bibr14-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.5.605"},{"key":"bibr15-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-003-0201-4"},{"key":"bibr16-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1177\/0333102410364676"},{"key":"bibr17-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1177\/0333102410364677"},{"key":"bibr18-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2010.01678.x"},{"key":"bibr19-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2011.02022.x"},{"key":"bibr20-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.505"},{"key":"bibr21-2042533312472115","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200161130-00004"},{"key":"bibr22-2042533312472115","first-page":"CD003633","volume":"1","author":"Costa J","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr23-2042533312472115","first-page":"CD004315","volume":"1","author":"Costa J","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr24-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2011.05.041"},{"key":"bibr25-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1007\/BF03033933"},{"key":"bibr26-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-010-5880-1"},{"key":"bibr27-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.coms.2007.12.003"},{"key":"bibr28-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.4805863"},{"key":"bibr29-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1179\/crn.2008.017"},{"key":"bibr30-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2008.03.008"},{"key":"bibr31-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(03)00153-8"},{"key":"bibr32-2042533312472115","doi-asserted-by":"publisher","DOI":"10.12968\/denu.2006.33.3.165"},{"key":"bibr33-2042533312472115","first-page":"CD008626","volume":"7","author":"Langevin P","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr34-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2010.04.043"},{"key":"bibr35-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1097\/01.wnf.0000172497.24770.b0"},{"key":"bibr36-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-282X2008000400012"},{"key":"bibr37-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-200503000-00010"},{"key":"bibr38-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2009.03.021"},{"key":"bibr39-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23372"},{"key":"bibr40-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.08.015"},{"key":"bibr41-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21054"},{"key":"bibr42-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2004.01.003"},{"key":"bibr43-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989570002-1"},{"key":"bibr44-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-011-0560-1"},{"key":"bibr45-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1002\/hed.1059"},{"key":"bibr46-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2000.106400"},{"key":"bibr47-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(99)70268-8"},{"key":"bibr48-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200309000-00010"},{"key":"bibr49-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1080\/16501970500515840"},{"key":"bibr50-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1177\/000348940211101002"},{"key":"bibr51-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(00)70198-7"},{"key":"bibr52-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1007\/PL00007520"},{"key":"bibr53-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2004.11.010"},{"key":"bibr54-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1177\/000348949410300105"},{"key":"bibr55-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20793"},{"key":"bibr56-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10420"},{"key":"bibr57-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000101713.81253.4C"},{"key":"bibr58-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200410000-00033"},{"key":"bibr59-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.stomax.2011.12.003"},{"key":"bibr60-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-6054(03)00115-6"},{"key":"bibr61-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.aanat.2011.09.002"},{"key":"bibr62-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7387.472"},{"key":"bibr63-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2008.08.010"},{"key":"bibr64-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21304"},{"key":"bibr65-2042533312472115","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.otorri.2011.02.004","volume":"63","author":"Conill Tobias N","year":"2012","journal-title":"Acta Otorrinolaringol Esp"},{"key":"bibr66-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2010.07.022"},{"key":"bibr67-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1985.01050030043017"},{"key":"bibr68-2042533312472115","first-page":"467","volume":"49","author":"Jankovic J","year":"1988","journal-title":"Adv Neurol"},{"key":"bibr69-2042533312472115","first-page":"271","volume":"35","author":"Fahn S LT","year":"1985","journal-title":"Neurology"},{"key":"bibr70-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(14)76386-X"},{"key":"bibr71-2042533312472115","first-page":"583","volume":"50","author":"Jankovic J","year":"1988","journal-title":"Adv Neurol"},{"key":"bibr72-2042533312472115","first-page":"CD004900","volume":"1","author":"Costa J","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr73-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.60.1.72"},{"key":"bibr74-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.49.7.827"},{"key":"bibr75-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880150909"},{"key":"bibr76-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1038\/sj.eye.6702866"},{"key":"bibr77-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0b013e3181d8e150"},{"key":"bibr78-2042533312472115","doi-asserted-by":"publisher","DOI":"10.3109\/09638280903514697"},{"key":"bibr79-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.06.031"},{"key":"bibr80-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1186\/1746-160X-5-18"},{"key":"bibr81-2042533312472115","first-page":"45","volume":"46","author":"Sapci T","year":"2008","journal-title":"Rhinology"},{"key":"bibr82-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2006.01.008"},{"key":"bibr83-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6657(11)70637-0"},{"key":"bibr84-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-010-2223-6"},{"key":"bibr85-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007-1323.2001.01982.x"},{"key":"bibr86-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.04.009"},{"key":"bibr87-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2008.545"},{"key":"bibr88-2042533312472115","doi-asserted-by":"publisher","DOI":"10.3109\/00016489509139348"},{"key":"bibr89-2042533312472115","first-page":"2397","volume":"90","author":"Pomprasit M","year":"2007","journal-title":"J Med Assoc Thai"},{"key":"bibr90-2042533312472115","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215111002581"}],"container-title":["JRSM Short Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2042533312472115","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2042533312472115","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2042533312472115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:41:29Z","timestamp":1777592489000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2042533312472115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2]]},"references-count":90,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2013,2]]}},"alternative-id":["10.1177\/2042533312472115"],"URL":"https:\/\/doi.org\/10.1177\/2042533312472115","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.726027963.793513714","asserted-by":"object"}]},"ISSN":["2042-5333"],"issn-type":[{"value":"2042-5333","type":"print"}],"subject":[],"published":{"date-parts":[[2013,2]]}}}