title: Botulinum toxin therapy: a tempting tool in the management of salivary secretory disorders.
abstract: OBJECTIVE
  The aim of the study was to investigate the feasibility and effectiveness of botulinum toxin therapy in salivary secretory disorders.
  
  
  METHODS
  We treated 24 patients with botulinum neurotoxin type A for drooling, salivary fistulas, sialoceles, recurrent parotitis, and Frey's syndrome; each parotid gland and submandibular gland received 25 to 60 and 10 to 40 mouse units, respectively, per session. All the patients other than those with Frey's syndrome underwent, for diagnostic purpose, color Doppler ultrasonography (Hitachi H 21; frequency, 7.5 MHz, Scanner, Kashiwa, Japan), and Minor's test was carried out for gustatory sweating; pretreatment magnetic resonance sialography (Philips Gyroscan Intera, Eindhoven, The Netherlands) and sialoendoscopy were also performed in selected cases. The follow-up included clinical and ultrasonographic examinations and Minor's test.
  
  
  RESULTS
  A clinical improvement was observed in all patients: complete clinical recovery in 12, subtotal in 6, and partial in 6. A self-assessment test suggested the cessation of sweating by the 10th day in most patients with Frey's syndrome. Botulinum toxin lost its effectiveness approximately after 4 months, requiring further administrations especially for drooling. No major side effects were observed with the exception of transitory paresis of the lower branch of the facial nerve in a patient with concomitant autonomic diabetic neuropathy.
  
  
  CONCLUSIONS
  Our findings suggest that botulinum toxin therapy is valid for the nonsurgical management of patients with salivary secretory disorders; the use of color Doppler ultrasonographic monitoring warrants the safety of the procedure.
authors: Department of Otorhinolaryngological and Ophthalmological Sciences, University of Milan, Policlinico Foundation IRCCS, Milan, Italy. pasquale.capaccio@unimi.it
authors: Pasquale
authors: P
authors: Capaccio
authors: Sara
authors: S
authors: Torretta
authors: Maurizio
authors: M
authors: Osio
authors: Davide
authors: D
authors: Minorati
authors: Francesco
authors: F
authors: Ottaviani
authors: Giuseppe
authors: G
authors: Sambataro
authors: Cristina
authors: C
authors: Nascimbene
authors: Lorenzo
authors: L
authors: Pignataro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012466:Salivary Gland Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D012469:Salivary Glands / Q000187:drug effects / Q000378:metabolism*; D012720:Severity of Illness Index; D012796:Sialography; D012798:Sialorrhea / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D019274:Botulinum Toxins, Type A