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Correction Of Velopharyngeal Insufficiency Secondary To Palatal Gunshot Wound: Case Presentation And Review Of The Literature, Rogelio Martinez-Wagner, Cristopher Cardenas-Cruz, Ivan Ortiz-Monasterio, Edgar Vargas, Maria M. Cabrera, Pablo A. Ysunza, M. Del Carmen Pamplona, Diane E. Campos-Lopez

Articles

Reconstruction of midfacial traumatic defects secondary to a gunshot wound (GSW) is one of the most challenging head surgeries. The high impact on the functional and aesthetic quality of life, and the small margin of error to achieve a successful outcome are significant hurdles in the surgical treatment of these cases. Here we report a 33-years old patient who suffered a GSW with an entrance wound penetrating between the soft and hard palate and an exit wound on the right malar region. A description of the case and a systematic review of the literature were conducted. The treatment depends on …

Surgical Correction Of Secondary Velopharyngeal Insufficiency After Gunshot Injury, Rogelio Martinez Wagner, Cristopher Cardenas Cruz, Ivan Ortiz-Monasterio Todd, Edgar Vargas Flores, Pablo Antonio Ysunza, Maria Mercedes Cabrera Cifuentes, Del Carmen Pamplona

Conference Presentation Abstracts

Objective: To present the surgical treatment of a case of Gunshot Wound (GSW) to the face with palatal involvement and Velopharyngeal Insufficiency (VI). A review of the related literature is also presented Methods: Case Report: Literature Review, description of the case, discussion, and conclusion. Results: We present a case of a 33 year old patient who suffered a GSW from a 9mm bullet. The patient was seen at the Emergency Department of the Hospital Gea Gonzalez in Mexico City 11 days after the incident. He presented with an entrance wound penetrating between soft and hard palate and an exit wound …

Post Covid-19 Infection Multisystem Inflammatory Syndrome In Adults Presenting With Pain, Ascending Weakness, And Paresthesias: A Case Report, Dustin Sielski, Jesse Lou, Timothy Bazil, Lisa Grant

Conference Presentation Abstracts

Case Diagnosis: Post COVID-19 infection multisystem inflammatory syndrome in adults presenting in a 28-year-old African American female with pain, ascending weakness, paresthesias, and chest pain. Case Description or Program Description: Patient with documented COVID-19 infection 5 weeks prior to arrival and presented with pain, paresthesias, and weakness in the bilateral lower extremities. Symptoms began shortly after patient recovered from COVID-19 infection, however, patient developed ascending weakness extending into the hands with left sided chest pain, prompting patient to present for evaluation. Setting: Major academic and referral center with level 1 adult trauma. Assessment/Results: Lumbar puncture and cerebrospinal fluid studies were …

Protective Effect Of Previous Spine Surgery In Traumatic Cervical Spinal Cord Injury: A Case Report, Jennifer Sloan, Ronald Taylor

Conference Presentation Abstracts

Case Diagnosis: Protective Effect of Previous Spine Surgery in Traumatic Cervical Spinal Cord Injury Case Description or Program Description: A 39-year-old female with previous C5-7 anterior cervical discectomy and fusion (ACDF) in 2017 presented following a fall from 20 feet while hiking. She was life flighted to an outside hospital and found to have multiple cervical spine fractures which were surgically repaired with C4-T2 fusion and C7 laminectomy. Imaging also showed retropulsion of osseous fragments in the spinal canal at the lower C7 level deforming the ventral cord contour, and cord edema at C7-T1. On evaluation, she had right lower …

Switching Adult Patients With Spasticity From Onabotulinumtoxina To Abobotulinumtoxina: A Real-World Data Analysis Across Three Us-Based Treatment Centers, Nate Way, Edward Dabrowski, Mitchell Paulin, Martin Taylor, John Madden, Amandeep Mann, Jonathan Bouchard

Conference Presentation Abstracts

Introduction: The therapeutic impact of botulinum toxin type A (BoNT-A) as first-line treatment for adult focal spasticity is well established across numerous therapeutic guidelines. However, relatively little real-world evidence exists to inform clinician decision-making when considering switching patients between BoNT-A products. This 5-year retrospective study aims to illustrate the safe transitioning of patients from onabotulinumtoxinA (ONA) to abobotulinumtoxinA (ABO) therapy in US centers that have considerable experience with BoNT-A usage in adults with spasticity.

Methods: Chart data from patients with upper limb spasticity (ULS), lower limb spasticity (LLS), or upper and lower limb spasticity (ULS+LLS) aged >18 years were collected …

Abobotulinumtoxina Efficacy And Safety In Children With Upper Limb Spasticity Previously Treated With Botulinum Toxin, Edward Dabrowski, Mauricio R. Delgado, Joyce Oleszek, Nigar Dursun, Jorge Carranza Del-Rio, Marcin Bonikowski, Benjamin Regnault, Simon Page, Ann Tilton

Conference Presentation Abstracts

Introduction: Primary endpoint analysis of this phase 3 study confirmed abobotulinumtoxinA (aboBoNT-A 8 U/kg and 16 U/kg) significantly reduced hypertonia versus the 2 U/kg low-dose control and was generally well tolerated (Delgado, et al, 2021). However, the impact of previous botulinum neurotoxin (BoNT) injections on treatment outcomes remains largely unexplored.

Methods: We present subgroup analyses of a phase 3 study conducted in children (aged 2-17) with cerebral palsy (Gross Motor Function Classification System [GMFCS] Levels I-IV) and spasticity in ≥1 upper limb. In the first treatment cycle, 210 children were randomized to treatment with aboBoNT-A 2 U/kg, 8 U/kg or …

Improvements In Lower Limb Spasticity-Related Pain In Children/Adolescents With Cerebral Palsy After Incobotulinumtoxina Injections, Florian Heinen, Michaela Bonfert, Petr Kanovsky, A Sebastian Schroeder, Henry Chambers, Edward Dabrowski, Thorin Geister, Angelika Hanschmann, Michael Althaus, Marta Banach, Deborah Gaebler-Spira

Conference Presentation Abstracts

Introduction: The effects of incobotulinumtoxinA on lower limb (LL) spasticity-related pain (SRP) over multiple treatment cycles (ICs) in children/adolescents (C/As) with cerebral palsy (CP) were analyzed using pooled data from three prospective phase 3 trials.

Patients and methods: C/As aged 2–17 years with CP-associated LL spasticity received incobotulinumtoxinA for 4 ICs. SRP was assessed with the Questionnaire on Pain caused by Spasticity (QPS) using C/A- (direct or via interviewer) and parent/caregiver (P/C)-completed LL modules. The pain population included all C/As with a key QPS item score >0 at baseline; post-baseline scores of 0 indicated complete pain relief.

Results: Data from …

Improvements In Upper Limb Spasticity-Related Pain In Children/Adolescents With Cerebral Palsy After Incobotulinumtoxina Injections, Florian Heinen, Michaela Bonfert, Petr Kanovsky, A Sebastian Schroeder, Henry Chambers, Edward Dabrowski, Thorin Geister, Angelika Hanschmann, Michael Althaus, Marta Banach, Deborah Gaebler-Spira

Conference Presentation Abstracts

Introduction: The effects of incobotulinumtoxinA on upper limb (UL) spasticity-related pain (SRP) over multiple treatment cycles (ICs) in children/adolescents (C/As) with cerebral palsy (CP) were analyzed using pooled data from two prospective phase 3 trials.

Patients and methods: C/As aged 2–17 years with CP-associated UL spasticity received incobotulinumtoxinA for 4 ICs. SRP was assessed with the Questionnaire on Pain caused by Spasticity (QPS) using C/A- (direct or via interviewer) and parent/caregiver (P/C)-completed UL modules. The pain population included all C/As with a key QPS item score >0 at baseline; post-baseline scores of 0 indicated complete pain relief.

Results: Data from …

Prevalence Of Spasticity-Related Pain In Children/Adolescents With Cerebral Palsy, Florian Heinen, Michaela Bonfert, Petr Kanovsky, A Sebastian Schroeder, Henry Chambers, Edward Dabrowski, Thorin Geister, Angelika Hanschmann, Michael Althaus, Marta Banach, Deborah Gaebler-Spira

Conference Presentation Abstracts

Introduction: This analysis determined the prevalence and intensity of spasticity-related pain (SRP) in children/adolescents (C/As) with cerebral palsy (CP).

Patients and methods: Baseline data from the prospective incobotulinumtoxinA trials TIM, TIMO and XARA were pooled. In all three studies, SRP was assessed in C/As aged 2–17 years with lower limb (LL) and/or upper limb (UL) spasticity using the Questionnaire on Pain caused by Spasticity (QPS); both self-reports (direct or via interviewer) and parent/caregiver (P/C) observer reports were included. A C/A was considered to have SRP if any QPS key item score was rated >0 at baseline. Individual QPS modules were …

Absence Of Neutralizing Antibody Formation During Incobotulinumtoxina Treatement Of Spasticity In Botulinum Toxin-Naive Children With Cerebral Palsy: Pooled Analysis Of Three Phase 3 Studies, Henry Chambers, Petr Kanovsky, A Sebastian Schroeder, Edward Dabrowski, Thorin Geister, Angelika Hanschmann, Irena Pulte, Michael Althaus, Marta Banach, Deborah Gaebler-Spira, Florian Heinen

Conference Presentation Abstracts

Introduction: The development of neutralizing antibodies (NAbs) has been linked to secondary non-response to botulinum neurotoxin type A (BoNT-A) injections. This may be of special concern when treating conditions like pediatric spasticity. We investigated NAb formation in three large Phase 3 studies with incobotulinumtoxinA, a BoNT-A lacking complexing proteins, in children/adolescents with cerebral palsy (CP).

Patients and methods: Patients with lower-limb (LL), upper-limb (UL), or combined LL/UL spasticity (2–17 years; uni- or bilateral CP; Ashworth Scale score ≥2 in clinical patterns for treatment) received total body weight incobotulinumtoxinA ≤16–20 U/kg (max. 400–500 U) depending on the study (TIM: NCT01893411; TIMO: …

What Is Meaningful Participation For Physical Therapists In Multidisciplinary Cancer Conferences And Tumor Boards?, Stacy Weber, Athena A. Manzino, Christopher M. Wilson, Nicole D. Booms

Articles

Tumor boards are multidisciplinary team meetings composed of providers from different specialties who collaborate to provide comprehensive cancer care. Although the term “tumor board” may be used commonly in practice, these meetings are often referred to as multidisciplinary cancer conferences (MCCs) within the literature and are referred to as such in this article. At this time, there is no current literature describing the role of physical therapists (PTs) and rehabilitation professionals as part of the MCC or multidisciplinary tumor boards. Yet, PTs are often included as part of this multidisciplinary team in cancer care. This inclusion has not completely shifted …

Safety Of Incobotulinumtoxina In Multipattern Treatment Of Upper And Lower Limb Spasticity In Children/Adolescents With Cerebral Palsy: Pooled Analysis Of 3 Large Phase 3 Studies, Marta Banach, Petr Kanovsky, A Sebastian Schroeder, Henry G. Chambers, Edward Dabrowski, Thorin L. Geister, Hanna Dersch, Michael Althaus, Deborah Gaebler-Spriag, Florian Heinen

Conference Presentation Abstracts

Introduction: This analysis assessed the safety and tolerability of repeated incobotulinumtoxinA treatment for lower-limb (LL), upper-limb (UL), or combined LL/UL spasticity in ambulant and non-ambulant children/adolescents with cerebral palsy (CP) using pooled data from 3 large Phase 3 studies.

Methods: Pediatric patients with spasticity (2–17 years of age; uni- or bilateral CP; Gross Motor Function Classification System [GMFCS] level I-V; Ashworth Scale [AS] score ≥2 in clinical patterns for treatment; clinical need for treatment) were enrolled. Patients received total body incobotulinumtoxinA doses of 16 U/kg body weight (BW, ≤400 U) for LL spasticity in 2 injection cycles (ICs) in TIM …

Improvement Of Spasticity-Related Pain With Incobotulinumtoxina Treatment In Children/Adolescents With Cerebral Palsy: Pooled Analysis Of 3 Phase 3 Studies, Florian Heinen, Petr Kanovsky, A Sebastian Schroeder, Henry G. Chambers, Edward Dabrowski, Thorin L. Geister, Hanna Dersch, Irena Pulte, Michael Althaus, Marta Banach, Deborah Gaebler-Spirag

Conference Presentation Abstracts

Introduction: Spasticity-related pain (SRP) in children and adolescents with cerebral palsy (CP) is common, often neglected, and impacts daily quality of life. We assessed the effect of incobotulinumtoxinA on SRP using pooled data from 3 large Phase 3 pediatric studies.

Methods: Ambulant and non-ambulant patients (2–17 years of age; uni- or bilateral CP; Ashworth Scale score ≥2 in clinical patterns for treatment) were enrolled. Patients received total body incobotulinumtoxinA doses of ≤16 U/kg (≤400 U) for lower-limb (LL) treatment in 2 injection cycles (ICs) in TIM (NCT01893411). In TIMO (NCT01905683), TIM completers and new recruits received 4 ICs with 16–20 …

Pooled Efficacy Analysis Of Incobotulinumtoxina In The Multipattern Treatment Of Upper- And Lower-Limb Spasticity In Children And Adolescents With Cerebral Palsy, Florian Heinen, Petr Kanovsky, A Sebastitan Schroeder, Henry G. Chambers, Edward Dabrowski, Thorin L. Geister, Hanna Dersch, Irena Pulte, Michael Althaus, Marta Banach, Deborah Gaebler-Spirag

Conference Presentation Abstracts

Introduction: This pooled analysis assessed the efficacy of incobotulinumtoxinA for lower-limb (LL) and upper-limb (UL) spasticity in children and adolescents with cerebral palsy (CP) using data from the first controlled injection cycle of 2 large Phase 3 studies, TIM (NCT01893411) and XARA (NCT02002884).

Methods: Ambulant and non-ambulant pediatric patients with spasticity due to CP (2–17 years of age; uni- or bilateral CP; Ashworth Scale [AS] score ≥2 in clinical patterns for treatment) were enrolled. Patients were randomized (2:1:1) to 3 incobotulinumtoxinA dose groups: 8, 6, 2 U/kg body weight (BW), maximum 200, 150, 50 U per LL clinical pattern in …