{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T02:36:59Z","timestamp":1773023819642,"version":"3.50.1"},"reference-count":9,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T00:00:00Z","timestamp":1640563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>It is well-established that botulinum toxin (BT) injections improve quality of life in patients with postparalytic hemifacial spasm. Nevertheless, injection-related pain and contracture-related pain have not yet been studied. The primary objective of our study was to evaluate injection-related pain in patients with facial palsy sequelae, and to compare the standard technique (syringe) with the Juvapen device. The secondary objective was to evaluate the improvement of contracture-related pain one month after BT injection. Methods: We conducted an observational, prospective, monocentric study based on 60 patients with facial palsy sequelae who received BT injections in our university ENT (ear, nose throat) department. There were 30 patients in the Juvapen group (J) and 30 in the standard technique group (ST). All patients completed Numerical Rating Scale (NRS) questionnaires immediately after the injections and one month later. Results: The average NRS score was 1.33\/10 with Juvapen and 2.24\/10 with the standard technique (p = 0.0058; Z = 2.75). In patients with contracture-related pain, the average NRS score was 3.53 before BT injection, and 0.41 one month after BT injection (p = 0.0001). Conclusions: Juvapen is a less-painful injection technique than the standard one. BT reduces contracture-related pain one month after injection.<\/jats:p>","DOI":"10.3390\/toxins14010020","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T01:20:43Z","timestamp":1640654443000},"page":"20","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pain in Patients with Post Paralytic Hemifacial Spasm: Before, during and after Botulinum Toxin Injections"],"prefix":"10.3390","volume":"14","author":[{"given":"Chlo\u00e9","family":"Wehrlin","sequence":"first","affiliation":[{"name":"ENT Department, Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Sorbonne Universit\u00e9, 75013 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5195-1760","authenticated-orcid":false,"given":"Diane","family":"Picard","sequence":"additional","affiliation":[{"name":"ENT Department, Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Sorbonne Universit\u00e9, 75013 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederic","family":"Tank\u00e9r\u00e9","sequence":"additional","affiliation":[{"name":"ENT Department, Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Sorbonne Universit\u00e9, 75013 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1569-3578","authenticated-orcid":false,"given":"R\u00e9mi","family":"Hervochon","sequence":"additional","affiliation":[{"name":"ENT Department, Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Sorbonne Universit\u00e9, 75013 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Foirest","sequence":"additional","affiliation":[{"name":"ENT Department, Piti\u00e9 Salp\u00eatri\u00e8re Hospital, Sorbonne Universit\u00e9, 75013 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/000164802760370736","article-title":"Bell\u2019s palsy: The spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies","volume":"122","author":"Peitersen","year":"2002","journal-title":"Acta Otolaryngol. Suppl."},{"key":"ref_2","first-page":"725","article-title":"Activity limitations and participation restrictions in patients with peripheral facial palsy: A cross-sectional study over a six-year period","volume":"56","author":"Pavese","year":"2020","journal-title":"Eur. J. Phys. Rehabil. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1097\/SCS.0000000000002758","article-title":"New Clinical Analysis and Device for Botox Injections","volume":"27","author":"Bertossi","year":"2016","journal-title":"J. Craniofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1097\/01.sap.0000139563.51598.75","article-title":"Evaluating the effects of ice application on the pain felt during botulinum toxin type-a injections: A prospective, randomized, single-blind controlled trial","volume":"53","author":"Sarifakioglu","year":"2004","journal-title":"Ann. Plast. 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Toxins, 9.","DOI":"10.3390\/toxins9090260"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1002\/lary.26356","article-title":"Quality of life before and after different treatment modalities in peripheral facial palsy: A systematic review","volume":"127","author":"Luijmes","year":"2017","journal-title":"Laryngoscope"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1001\/jama.2019.4582","article-title":"The Importance of Predefined Rules and Prespecified Statistical Analyses: Do Not Abandon Significance","volume":"321","author":"Ioannidis","year":"2019","journal-title":"JAMA"}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/14\/1\/20\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:54:17Z","timestamp":1760169257000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/14\/1\/20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,27]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["toxins14010020"],"URL":"https:\/\/doi.org\/10.3390\/toxins14010020","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,27]]}}}