title: Botulinum toxin in preparation of oral cavity for microsurgical reconstruction.
abstract: 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.
authors.affiliation: Dipartimento di Discipline Chirurgiche ed Oncologiche, Cattedra di Chirurgia Plastica, Università di Palermo, Parlermo, Italy. dilsister@libero.it
authors.forename: Bartolo
authors.initials: B
authors.lastname: Corradino
authors.forename: Sara
authors.initials: S
authors.lastname: Di Lorenzo
authors.forename: Carmela
authors.initials: C
authors.lastname: Mossuto
authors.forename: Renato Patrizio
authors.initials: RP
authors.lastname: Costa
authors.forename: Francesco
authors.initials: F
authors.lastname: Moschella
mesh_terms: 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
chemical_list: D019274:Botulinum Toxins, Type A