title: Botulinum toxin treatment of salivary fistulas following parotidectomy: follow-up results.
abstract: BACKGROUND
  Salivary fistulas are a well-known sequel of parotidectomy, and successful treatment with botulinum toxin has been demonstrated in individual cases. Here, we report on 12 patients with fistulas treated following parotidectomy for various indications.
  
  
  RESULTS
  Injection of botulinum toxin type A into the residual gland tissue was the initial treatment. After early intervention (within 6 weeks after development of the fistula), only one fistula remained (9 of 10 fistulas treated early only with botulinum toxin). One patient with early intervention did not want to wait for the botulinum toxin treatment to take effect and demanded early surgical revision, which was successful. In one patient with a permanent fistula, botulinum toxin treatment began 420 days after the operation and was unsuccessful. No side effects were evident after the treatment.
  
  
  CONCLUSIONS
  In summary, botulinum toxin injections into the parotid tissue remaining after surgery appear to be an effective treatment for salivary fistulas following parotidectomy.
authors.affiliation: Department of Otorhinolaryngology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075, Göttingen, Lower Saxony, Germany, rlaskaw@gwdg.de.
authors.forename: Rainer
authors.initials: R
authors.lastname: Laskawi
authors.forename: Jan
authors.initials: J
authors.lastname: Winterhoff
authors.forename: Sabrina
authors.initials: S
authors.lastname: Köhler
authors.forename: Laura
authors.initials: L
authors.lastname: Kottwitz
authors.forename: Christoph
authors.initials: C
authors.lastname: Matthias
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D015331:Cohort Studies; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000188:drug therapy*; D010306:Parotid Gland / Q000187:drug effects / Q000601:surgery*; D010307:Parotid Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000188:drug therapy*; D012189:Retrospective Studies; D012467:Salivary Gland Fistula / Q000188:drug therapy*
chemical_list: D019274:Botulinum Toxins, Type A