[Interests of the ultrasound-guidance in the treatment of drooling through botulinum toxin injections, our experience over 10 years].
OBJECTIVE
To report about our 10 years' experience about the treatment of drooling by ultrasound guided botulinum toxin injections.


METHODS
Retrospective monocentric study including all the patients suffering from drooling and treated by ultrasound-guided botulinum toxin injections into the salivary glands between 2004 and 2015. The etiology of r drooling, the doses of toxin, the injected glands, the size of the glands measured by ultrasonography, the effectiveness of the treatment and the side effects were assessed.


RESULTS
Two hundred and ninety-two injections sessions were performed in 61 patients. Exactly 70.5 % of patients reported an improvement after the first session. Parkinson's disease was the main etiology of drooling (43 % of the patients). Eleven patients reported side effects. The salivary gland volume reduced after treatment in 46 % of the patients.


CONCLUSIONS
The interest of ultrasound-guidance is to make sure about the intraglandular injection, to lower the risk for extraglandular diffusion of the toxin responsible for swallowing disorders and to allow for an adaptation of the doses to the volume of the salivary glands, which may vary during treatment.
Service d'ORL et de chirurgie de la face et du cou, Fondation Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France. Electronic address: mmailly@for.paris.
M
M
Mailly
Service d'ORL et de chirurgie de la face et du cou, Fondation Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France.
C
C
Rebours
Service d'imagerie médicale, Fondation Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France.
P
P
Koskas
Service d'ORL et de chirurgie de la face et du cou, Fondation Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France.
P
P
Klap
Service d'ORL et de chirurgie de la face et du cou, Fondation Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France.
D
D
Ayache
Service d'ORL et de chirurgie de la face et du cou, Fondation Adolphe-de-Rothschild, 29, rue Manin, 75019 Paris, France.
M
M
Cohen
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 / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012469:Salivary Glands / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology; D012798:Sialorrhea / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
D019274:Botulinum Toxins, Type A
Bavage; Botulinum toxin; Drooling; Glandes salivaires; Salivary glands; Toxine botulique; Ultrasonography; Échographie