Ultrasound-guided versus 'blind' intraparotid injections of botulinum toxin-A for the treatment of sialorrhoea in patients with Parkinson's disease.
OBJECTIVE
To investigate the efficacy and safety of intraparotid botulinum toxin-A (BTX-A) injections into parotid gland using ultrasound-guided versus nonguided techniques for the treatment of sialorrhoea in patients with Parkinson's disease (PD).


METHODS
15 patients with PD and sialorrhoea were included and divided into two groups. Group A patients (n=8) were injected with BTX-A using ultrasound guidance. Group B patients (n=7) were injected with BTX-A without ultrasound guidance. Saliva secretion was assessed quantitatively at baseline and at weeks 1, 4, and 12. Patients and/or caregivers also assessed the saliva secretion using visual analog scale (VAS).


RESULTS
All patients except one reported subjective improvement in sialorrhoea at the first week. Group A patients showed significantly higher rate of saliva reduction at the first week, whereas in Group B the reduction was not statistically significant from baseline at the first week (P>0.05). Comparisons of quantitative saliva assessments at each follow-up visit also showed that ultrasound-guided injections were superior to blind injections for saliva reduction. VAS scores showed an improvement in the mean rate of saliva secretion in each group at first week (P<0.05). Two patients suffered from dry mouth in mild severity lasting 1 month.


CONCLUSIONS
Intraparotid BTX-A injections using ultrasound guidance may be an effective, easy, and safe treatment for parkinsonian sialorrhoea.
Dogu
Okan
O
Department of Neurology, Faculty of Medicine, Tip Fakultesi Hastanesi, Noroloji Anabilim Dali, Zeytinlibahce cad., Mersin Universitesi, 33070 Mersin, Turkey. okandogu@mersin.edu.tr
Apaydin
Demir
D
Sevim
Serhan
S
Talas
Derya Umit
DU
Aral
Mihriban
M
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010306:Parotid Gland / Q000000981:diagnostic imaging* / Q000187:drug effects*; D017060:Patient Satisfaction; D012472:Salivation / Q000187:drug effects; D012798:Sialorrhea / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D014159:Transducers; D016896:Treatment Outcome; D014463:Ultrasonography / Q000295:instrumentation*
D000978:Antiparkinson Agents; D019274:Botulinum Toxins, Type A