title: Ultrasound-guided botulinum toxin A injection: an alternative treatment for dribbling.
abstract: Dribbling (sialorrhoea) affects about 10 per cent of patients with chronic neurological disease. The variety of treatments currently available is unsatisfactory. This study was a clinical trial of the efficacy of ultrasound-guided, intraglandular injection of botulinum toxin A for dribbling, performed within the otorhinolaryngology department of the National University of Malaysia. Both pairs of parotid and submandibular glands received 25 U each of botulinum toxin A. Twenty patients were enrolled in the study. The median age was 15 years. All 20 patients (or their carers) reported a distinct improvement in symptoms after injection. Using the Wilcoxon signed rank test, there were significant reductions in dribbling rating score, dribbling frequency score, dribbling severity score, dribbling visual analogue score and towel changes score, comparing pre- and post-injection states (p<0.001). There were no complications or adverse effects during or after the injection procedure. Intraglandular, major salivary gland injection of botulinum toxin A is an effective treatment to reduce dribbling. Ultrasound guidance enhances the accuracy of this procedure and minimises the risk of complication.
authors.affiliation: Department of Otorhinolaryngology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia. marinadr72@yahoo.co.uk
authors.forename: M B
authors.initials: MB
authors.lastname: Marina
authors.forename: A
authors.initials: A
authors.lastname: Sani
authors.forename: A H
authors.initials: AH
authors.lastname: Hamzaini
authors.forename: B B
authors.initials: BB
authors.lastname: Hamidon
mesh_terms: D000293:Adolescent; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D001927:Brain Diseases / Q000150:complications; D002648:Child; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D008296:Malaysia; D008297:Male; D009498:Neurotoxins / Q000008:administration & dosage*; D010306:Parotid Gland / Q000187:drug effects*; D017060:Patient Satisfaction; D012798:Sialorrhea / Q000188:drug therapy* / Q000209:etiology; D018709:Statistics, Nonparametric; D013363:Submandibular Gland / Q000187:drug effects*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D009498:Neurotoxins; D019274:Botulinum Toxins, Type A