What treatment options do you recommend to patients with microstomia secondary to scleroderma?
Have you tried hyaluronidase?
Answer from: at Academic Institution
Perioral and masseter botox 8U upper lip and 4U lower lip. 16U per masseter.
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Answer from: at Academic Institution
Perioral hyaluronidase can work great and without the potential of weakening the muscles. We do 200U diluted into a total of 6 mL (2 3mL syringes). Nerve blocks and topical 30% lidocaine for 20-30 min then inject in two lines on each cutaneous lip (one just above/blow vermilion border and one above/...