Botulinum toxin type-A (Botox-A) injections for treatment of sialorrhoea in adults: a New Zealand study.
OBJECTIVE
We report our initial experience using Botox-A injection to the salivary glands to control sialorrhoea.


METHODS
Eight adult patients with significant sialorrhoea were referred from an inpatient rehabilitation unit, GP referral, and internal medicine department. All subjects underwent bilateral submandibular gland injections and, in addition, one patient (the first) also had intraparotid injections. Injections were performed with ultrasound guidance at Dunedin Hospital, New Zealand. Six patients received a total of 30 Units and two patients received 60 Units in the submandibular glands without any complications. Outcome was assessed using a drooling scale and VAS self report of sialorrhoea.


RESULTS
Of the eight patients treated, six reported a marked reduction in salivation following treatment, and one patient improved partially. One patient did not find the Botox injection helpful in controlling sialorrhoea and was offered escalation of the Botox dose with a subsequent partial response. No serious adverse events occurred, and no procedure-related complications were noted.


CONCLUSIONS
Our initial experience suggests that injection of Botox-A injected at a relatively low dose to the submandibular glands can be used to achieve desired results for the treatment of sialorrhoea. This is an easily performed procedure with low morbidity and can be recommended as a first-line intervention in the treatment of adult sialorrhoea.
Shetty
Subhaschandra
S
Whangarei Base Hospital, Whangarei. subhash@nhl.co.nz
Dawes
Patrick
P
Ruske
Dean
D
Al-qudah
Mohannad
M
Lyons
Brett
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D012798:Sialorrhea / Q000188:drug therapy*; D013363:Submandibular Gland; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A