Botulinum toxin in the treatment of sialorrhea

Background/Aim. Botulinum toxin-A (BTX-A) is known to block the release of acetylcholine from motor and autonomic nerve terminals and may significantly decrease saliva production when injected intraglandulary. The aim of this study was to evaluate effects of BTX-A injections in the treatment of disa...

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Main Authors: Svetel Marina, Vasić Milan, Dragašević Nataša, Pekmezović Tatjana, Petrović Igor, Kostić Vladimir S.
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2009-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2009/0042-84500901009S.pdf
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author Svetel Marina
Vasić Milan
Dragašević Nataša
Pekmezović Tatjana
Petrović Igor
Kostić Vladimir S.
author_facet Svetel Marina
Vasić Milan
Dragašević Nataša
Pekmezović Tatjana
Petrović Igor
Kostić Vladimir S.
author_sort Svetel Marina
collection DOAJ
description Background/Aim. Botulinum toxin-A (BTX-A) is known to block the release of acetylcholine from motor and autonomic nerve terminals and may significantly decrease saliva production when injected intraglandulary. The aim of this study was to evaluate effects of BTX-A injections in the treatment of disabling sialorrhea in various neurological disorders. Methods. This study included 19 consecutive patients with significant sialorrhea associated with various neurological disorders. Out of them 13 patients were with Parkinson's disease, two with pantothenate kinase-associated neurodegeneration, two with multiple system atrophy, one with Wilson's disease, and one patient with postoperative sialorrhea. Botulinum toxin-A (Dysport®, Ipsen Pharma) was injected into the parotid glands with (n = 7 patients) or without (n = 12 patients) ultrasound guidance. All the patients were scored before and after the treatment and in weekly intervals thereafter using the salivation item of the part II (Activities of Daily Living) of the Unified Parkinson's Disease Rating Scale (UPDRS). Results. Thirteen patients (68%) reported beneficial effect of BTX-A injection, while 6 of them (32%) had no response at all. The sialorrhea scores before and after the treatment were 3.1 ± 0.1 (range 2-4) and 1.8 ± 0.1 (range 0- 3), respectively (t = 5.636; p < 0.001). There was no difference in the magnitude of response between the groups with (t = 4.500; p = 0.004) and without (t = 3.674; p = 0.005) ultrasound control of injection sites. Adverse effects were registered in 5 patients (26%). Conclusions. Botulinum toxin-A injections to easily accessible parotid glands, without necessity for ultrasound guidance, are safe and efficaceous treatment for sialorrhea in different neurological disorders.
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spelling doaj-art-9b35dfffbb054d058c9f03c22d4da8bb2025-08-20T03:36:57ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502009-01-0166191210.2298/VSP0901009SBotulinum toxin in the treatment of sialorrheaSvetel MarinaVasić MilanDragašević NatašaPekmezović TatjanaPetrović IgorKostić Vladimir S.Background/Aim. Botulinum toxin-A (BTX-A) is known to block the release of acetylcholine from motor and autonomic nerve terminals and may significantly decrease saliva production when injected intraglandulary. The aim of this study was to evaluate effects of BTX-A injections in the treatment of disabling sialorrhea in various neurological disorders. Methods. This study included 19 consecutive patients with significant sialorrhea associated with various neurological disorders. Out of them 13 patients were with Parkinson's disease, two with pantothenate kinase-associated neurodegeneration, two with multiple system atrophy, one with Wilson's disease, and one patient with postoperative sialorrhea. Botulinum toxin-A (Dysport®, Ipsen Pharma) was injected into the parotid glands with (n = 7 patients) or without (n = 12 patients) ultrasound guidance. All the patients were scored before and after the treatment and in weekly intervals thereafter using the salivation item of the part II (Activities of Daily Living) of the Unified Parkinson's Disease Rating Scale (UPDRS). Results. Thirteen patients (68%) reported beneficial effect of BTX-A injection, while 6 of them (32%) had no response at all. The sialorrhea scores before and after the treatment were 3.1 ± 0.1 (range 2-4) and 1.8 ± 0.1 (range 0- 3), respectively (t = 5.636; p < 0.001). There was no difference in the magnitude of response between the groups with (t = 4.500; p = 0.004) and without (t = 3.674; p = 0.005) ultrasound control of injection sites. Adverse effects were registered in 5 patients (26%). Conclusions. Botulinum toxin-A injections to easily accessible parotid glands, without necessity for ultrasound guidance, are safe and efficaceous treatment for sialorrhea in different neurological disorders.http://www.doiserbia.nb.rs/img/doi/0042-8450/2009/0042-84500901009S.pdfsialorrheaParkinson diseaseneurodegenerative diseasesbotulinum toxins
spellingShingle Svetel Marina
Vasić Milan
Dragašević Nataša
Pekmezović Tatjana
Petrović Igor
Kostić Vladimir S.
Botulinum toxin in the treatment of sialorrhea
Vojnosanitetski Pregled
sialorrhea
Parkinson disease
neurodegenerative diseases
botulinum toxins
title Botulinum toxin in the treatment of sialorrhea
title_full Botulinum toxin in the treatment of sialorrhea
title_fullStr Botulinum toxin in the treatment of sialorrhea
title_full_unstemmed Botulinum toxin in the treatment of sialorrhea
title_short Botulinum toxin in the treatment of sialorrhea
title_sort botulinum toxin in the treatment of sialorrhea
topic sialorrhea
Parkinson disease
neurodegenerative diseases
botulinum toxins
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2009/0042-84500901009S.pdf
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AT pekmezovictatjana botulinumtoxininthetreatmentofsialorrhea
AT petrovicigor botulinumtoxininthetreatmentofsialorrhea
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