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.
Department of Neurology, Faculty of Medicine, Tip Fakultesi Hastanesi, Noroloji Anabilim Dali, Zeytinlibahce cad., Mersin Universitesi, 33070 Mersin, Turkey. okandogu@mersin.edu.tr
Okan
O
Dogu
Demir
D
Apaydin
Serhan
S
Sevim
Derya Umit
DU
Talas
Mihriban
M
Aral
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