Botulinum toxin in preparation of oral cavity for microsurgical reconstruction.
CONCLUSIONS
Infiltration of botulinum toxin in the major salivary glands allows a temporary reduction of salivation that begins 8 days afterwards and returns to normal within 2 months. The inhibition of salivary secretion, carried out before the oral cavity reconstructive surgery, could allow a reduction of the incidence of oro-cutaneous fistulas and local complications.


OBJECTIVE
Saliva stagnation is a risk factor for patients who have to undergo reconstructive microsurgery of the oral cavity, because of fistula formation and local complications in the oral cavity. The authors suggest infiltration of botulinum toxin in the major salivary glands to reduce salivation temporarily during the healing stage.


METHODS
During the preoperative stage, 20 patients with oral cavity carcinoma who were candidates for microsurgical reconstruction underwent sialoscintigraphy and a quantitative measurement of the salivary secretion. Injection of botulinum toxin was carried out in the salivary glands 4 days before surgery. The saliva quantitative measurement was repeated 3 and 8 days after infiltration, sialoscintigraphy after 15 days.


RESULTS
In all cases, the saliva quantitative measurement revealed a reduction of 50% and 70% of the salivary secretion after 72 h and 8 days, respectively. A lower rate of local complications was observed.
Corradino
Bartolo
B
Dipartimento di Discipline Chirurgiche ed Oncologiche, Cattedra di Chirurgia Plastica, Università di Palermo, Parlermo, Italy. dilsister@libero.it
Di Lorenzo
Sara
S
Mossuto
Carmela
C
Costa
Renato Patrizio
RP
Moschella
Francesco
F
D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D006801:Humans; D008866:Microsurgery; D009060:Mouth Floor / Q000601:surgery; D009062:Mouth Neoplasms / Q000601:surgery*; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D011300:Preoperative Care; D012469:Salivary Glands / Q000187:drug effects*; D012472:Salivation / Q000187:drug effects; D013524:Surgical Flaps; D014062:Tongue Neoplasms / Q000601:surgery
D019274:Botulinum Toxins, Type A