Abstract：
BACKGROUND: The rising use of soft tissue fillers for aesthetic procedures has seen an increase in complications, including vascular occlusions and neurological symptoms that resemble stroke. This study synthesizes information on central nervous system (CNS) complications post-filler injections and evaluates the effectiveness of hyaluronidase (HYAL) treatment.
METHODS: A thorough search of multiple databases, including PubMed, EMBASE, Scopus, Web of Science, Google Scholar, and Cochrane, focused on publications from January 2014 to January 2024. Criteria for inclusion covered reviews and case reports that documented CNS complications related to soft tissue fillers. Advanced statistical and computational techniques, including logistic regression, machine learning, and Bayesian analysis, were utilized to dissect the factors influencing therapeutic outcomes.
RESULTS: The analysis integrated findings from 20 reviews and systematic analyses, with 379 cases reported since 2018. Hyaluronic acid (HA) was the most commonly used filler, particularly in nasal region injections. The average age of patients was 38, with a notable increase in case reports in 2020. Initial presentation data revealed that 60.9% of patients experienced no light perception, while ptosis and ophthalmoplegia were present in 54.3 and 42.7% of cases, respectively. The statistical and machine learning analyses did not establish a significant linkage between the HYAL dosage and patient recovery; however, the injection site emerged as a critical determinant.
CONCLUSIONS: The study concludes that HYAL treatment, while vital for managing complications, varies in effectiveness based on the injection site and the timing of administration. The non-Newtonian characteristics of HA fillers may also affect the incidence of complications. The findings advocate for tailored treatment strategies incorporating individual patient variables, emphasizing prompt and precise intervention to mitigate the adverse effects of soft tissue fillers.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
METHODS: A thorough search of multiple databases, including PubMed, EMBASE, Scopus, Web of Science, Google Scholar, and Cochrane, focused on publications from January 2014 to January 2024. Criteria for inclusion covered reviews and case reports that documented CNS complications related to soft tissue fillers. Advanced statistical and computational techniques, including logistic regression, machine learning, and Bayesian analysis, were utilized to dissect the factors influencing therapeutic outcomes.
RESULTS: The analysis integrated findings from 20 reviews and systematic analyses, with 379 cases reported since 2018. Hyaluronic acid (HA) was the most commonly used filler, particularly in nasal region injections. The average age of patients was 38, with a notable increase in case reports in 2020. Initial presentation data revealed that 60.9% of patients experienced no light perception, while ptosis and ophthalmoplegia were present in 54.3 and 42.7% of cases, respectively. The statistical and machine learning analyses did not establish a significant linkage between the HYAL dosage and patient recovery; however, the injection site emerged as a critical determinant.
CONCLUSIONS: The study concludes that HYAL treatment, while vital for managing complications, varies in effectiveness based on the injection site and the timing of administration. The non-Newtonian characteristics of HA fillers may also affect the incidence of complications. The findings advocate for tailored treatment strategies incorporating individual patient variables, emphasizing prompt and precise intervention to mitigate the adverse effects of soft tissue fillers.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
摘要：
背景：在美容手术中越来越多地使用软组织填充物，并发症有所增加，包括血管闭塞和类似中风的神经症状。这项研究综合了填充剂注射后中枢神经系统（CNS）并发症的信息，并评估了透明质酸酶（HYAL）治疗的有效性。
方法：对多个数据库进行彻底搜索，包括PubMed,EMBASE,Scopus,WebofScience,谷歌学者，还有Cochrane,重点关注2014年1月至2024年1月的出版物。纳入标准涵盖了记录与软组织填充物相关的CNS并发症的综述和病例报告。先进的统计和计算技术，包括逻辑回归，机器学习,和贝叶斯分析，用于剖析影响治疗结果的因素。
结果：分析综合了20篇综述和系统分析的结果，自2018年以来报告了379例病例。透明质酸（HA）是最常用的填料，特别是在鼻腔区域注射。患者的平均年龄为38岁，2020年病例报告显着增加。初始演示数据显示，60.9%的患者没有光感知，而在54.3和42.7%的病例中存在上清液和眼肌麻痹，分别。统计和机器学习分析没有建立HYAL剂量和患者恢复之间的显著联系;然而,注射部位是一个关键的决定因素.
结论：该研究得出结论，HYAL治疗，虽然对于管理并发症至关重要，根据注射部位和给药时间的不同，有效性也不同。HA填料的非牛顿特性也可能影响并发症的发生率。研究结果提倡结合患者个体变量的量身定制的治疗策略，强调及时和精确的干预，以减轻软组织填充物的不利影响。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
方法：对多个数据库进行彻底搜索，包括PubMed,EMBASE,Scopus,WebofScience,谷歌学者，还有Cochrane,重点关注2014年1月至2024年1月的出版物。纳入标准涵盖了记录与软组织填充物相关的CNS并发症的综述和病例报告。先进的统计和计算技术，包括逻辑回归，机器学习,和贝叶斯分析，用于剖析影响治疗结果的因素。
结果：分析综合了20篇综述和系统分析的结果，自2018年以来报告了379例病例。透明质酸（HA）是最常用的填料，特别是在鼻腔区域注射。患者的平均年龄为38岁，2020年病例报告显着增加。初始演示数据显示，60.9%的患者没有光感知，而在54.3和42.7%的病例中存在上清液和眼肌麻痹，分别。统计和机器学习分析没有建立HYAL剂量和患者恢复之间的显著联系;然而,注射部位是一个关键的决定因素.
结论：该研究得出结论，HYAL治疗，虽然对于管理并发症至关重要，根据注射部位和给药时间的不同，有效性也不同。HA填料的非牛顿特性也可能影响并发症的发生率。研究结果提倡结合患者个体变量的量身定制的治疗策略，强调及时和精确的干预，以减轻软组织填充物的不利影响。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
