Document Detail

The treatment of drooling by ultrasound-guided intraglandular injections of botulinum toxin type A into the salivary glands.
MedLine Citation:
PMID:  12514392     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The aim of the study was to present the background, procedure, and technique of bilateral ultrasound-guided, single-dose injections of botulinum toxin type A (BTX) into the salivary glands in patients with severe drooling. STUDY DESIGN: Clinical trial. METHODS: Initially, an in vitro study was performed to determine the volume of the dilution of BTX required for optimal spreading and to gain insight in the spreading pattern of the fluid in the submandibular gland. Subsequently, patients with severe drooling were included in a clinical study. Salivary flow was measured under standardized conditions, and BTX was injected into the submandibular glands with the patient under general anesthesia and with ultrasound guidance as an outpatient procedure or during a short stay at the daytime care unit. RESULTS: BTX for each gland should be diluted in a volume of 1 to 1.5 mL saline to achieve adequate spreading within the gland and to diminish the risk of diffusion into surrounding structures. With ultrasound guidance, separate structures surrounding the glands and structures within the glandular parenchyma are well recognized and injection errors can be avoided. CONCLUSIONS: With the procedure described, it is possible to accurately inject BTX directly into the glandular parenchyma and to visualize spreading of the fluid in the glandular parenchyma. It is found to be a safe method that guarantees an optimal clinical effect and avoids potentially harmful side effects. We recommend ultrasound guidance if injections of BTX into the salivary glands are considered.
Peter H Jongerius; Frank Joosten; Frank J A Hoogen; Fons J M Gabreels; Jan J Rotteveel
Publication Detail:
Type:  Comparative Study; In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Laryngoscope     Volume:  113     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-06     Completed Date:  2003-01-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  107-11     Citation Subset:  IM    
Department of Rehabilitation, University Medical Center St. Radboud, Nijmegen, The Netherlands.
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MeSH Terms
Botulinum Toxin Type A / administration & dosage*
Cerebral Palsy / complications*,  diagnosis
Child, Preschool
Follow-Up Studies
Injections, Intralesional
Salivary Glands / drug effects*,  ultrasonography*
Sialorrhea / drug therapy*,  etiology,  ultrasonography
Treatment Outcome
Reg. No./Substance:
0/Botulinum Toxin Type A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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