title: [Hypersalivation - inauguration of the S2k Guideline (AWMF) in short form].
abstract: Hypersalivation describes a relatively excessive salivary flow, which wets the patient himself and his surroundings. It may result because of insufficient oro-motor function, dysphagia, decreased central control and coordination. This reduces social interaction chances and burdens daily care. Multidisciplinary diagnostic and treatment evaluation is recommended already at early stage and focus on dysphagia, and saliva aspiration. Therefore, a multidisciplinary S2k guideline was developed. Diagnostic tools such as fiberoptic endoscopic evaluation of swallowing and videofluoroscopic swallowing studies generate important data on therapy selection and control. Especially traumatic and oncologic cases profit from swallowing therapy programmes in order to activate compensation mechanisms. In children with hypotonic oral muscles, oralstimulation plates can induce a relevant symptom release because of the improved lip closure. In acute hypersalivation, the pharmacologic treatment with glycopyrrolate and scopolamine in various applications is useful but its value in long-term usage critical. The injection of botulinum toxin into the salivary glands has shown safe and effective results with long lasting saliva reduction. Surgical treatment should be reserved for isolated cases. External radiation is judged as ultima ratio. Therapy effects and symptom severity has to be followed, especially in neurodegenerative cases. The resulting xerostomia should be critically evaluated by the responsible physician regarding oral and dental hygiene.
authors.affiliation: HNO-Klinik, Lübeck, Universität zu Lübeck, Lübeck.
authors.forename: A
authors.initials: A
authors.lastname: Steffen
authors.forename: D
authors.initials: D
authors.lastname: Beutner
authors.forename: S
authors.initials: S
authors.lastname: Hakim
authors.forename: W
authors.initials: W
authors.lastname: Jost
authors.forename: K G
authors.initials: KG
authors.lastname: Kahl
authors.forename: R
authors.initials: R
authors.lastname: Laskawi
authors.forename: R
authors.initials: R
authors.lastname: Lencer
authors.forename: V
authors.initials: V
authors.lastname: Mall
authors.forename: F-W
authors.initials: FW
authors.lastname: Mehrhoff
authors.forename: T
authors.initials: T
authors.lastname: Meyners
authors.forename: R
authors.initials: R
authors.lastname: Schönweiler
authors.forename: S
authors.initials: S
authors.lastname: Schröder
authors.forename: H
authors.initials: H
authors.lastname: Schröter-Morasch
authors.forename: M
authors.initials: M
authors.lastname: Schuster
authors.forename: S
authors.initials: S
authors.lastname: Steinlechner
authors.forename: J
authors.initials: J
authors.lastname: Winterhoff
authors.forename: J
authors.initials: J
authors.lastname: Zenk
authors.forename: O
authors.initials: O
authors.lastname: Guntinas-Lichius
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D019274:Botulinum Toxins, Type A / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D019317:Evidence-Based Medicine; D005081:Exercise Therapy; D005858:Germany; D006024:Glycopyrrolate / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D033183:Interdisciplinary Communication; D009970:Orthodontics; D011015:Pneumonia, Aspiration / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D012601:Scopolamine / Q000009:adverse effects / Q000627:therapeutic use; D012798:Sialorrhea / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*
chemical_list: D012601:Scopolamine; D019274:Botulinum Toxins, Type A; D006024:Glycopyrrolate