title: [Botulinum Toxin in Functional Hypersalivation--All about Dosage?].
abstract: BACKGROUND
  The use of botulinum toxin injection in the salivary gland, is taking an increasing significance in the treatment of functional hypersalivation today. With due regard to the off -label use and the prospect of success, dosage levels are not yet standardized.
  
  
  METHODS
  In a retrospective study, 54 patients resp. 117 treatments were analysed over a period of 5 years according to their dosage levels of botulinum toxin, outcome and side effects.
  
  
  RESULTS
  In 90% of the cases, a reduction of saliva after botulinum toxin injections was reported, although a significant number of patients wished for an even greater effect. Compared to the first botulinum toxin injection, we therefore used a higher dosage plan in the following treatment in order to achieve better clinical results. Besides not enough saliva reduction, the main side effects were swallowing problems and thick or sticky saliva in patients with a tracheal cannula. With the exception of insufficient saliva reduction, the other described side effects were irrespective to the dosage level.
  
  
  CONCLUSIONS
  Botulinum toxin injection as a treatment of hypersalivation is an effective method with only minor side effects, even in increased dosage levels. Nevertheless, certain modifications according to each individual treatment are required. Possible side effects such as swallowing problems or non-responding situations should always be part of informed consent, especially as the latter is even possible for higher dosage levels.
authors.affiliation: HNO-Klinik, Universität zu Lübeck, Lübeck.
authors.forename: A
authors.initials: A
authors.lastname: Steffen
authors.affiliation: Klinik für HNO-Heilkunde, Universität zu Lübeck, Lübeck.
authors.forename: K
authors.initials: K
authors.lastname: Hasselbacher
authors.affiliation: Klinik für Neurologie, Universität zu Lübeck, Lübeck.
authors.forename: N
authors.initials: N
authors.lastname: Brüggemann
authors.affiliation: Klinik für HNO-Heilkunde, Universität zu Lübeck, Lübeck.
authors.forename: S
authors.initials: S
authors.lastname: Heinrichs
authors.affiliation: Phoniatrie, Universitätsklinikum Schleswig-Holstein.
authors.forename: R
authors.initials: R
authors.lastname: Schönweiler
authors.affiliation: Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Lübeck.
authors.forename: B
authors.initials: B
authors.lastname: Wollenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019233:Retreatment; D012189:Retrospective Studies; D012469:Salivary Glands / Q000187:drug effects; D012472:Salivation / Q000187:drug effects; D012798:Sialorrhea / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D019274:Botulinum Toxins, Type A