The role of radiation therapy in the management of sialorrhea: A systematic review

Hawkey, Nathan; Zaorsky, Nicholas G.; Galloway, Thomas J.

doi:10.1002/lary.25444

Cited by 41 publications

(30 citation statements)

References 31 publications

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“…It is usually used following the failure to respond to or tolerate treatment with anticholinergic drugs and botulinum toxin. There are several retrospective and prospective studies, carried out in patients with Parkinson’s disease and motor neurone disease, reporting objective reductions in saliva production and improvements in patient symptoms 34. While these studies did not include control groups, the same patients had previously failed to achieve symptom control with other available treatments for sialorrhoea.…”

Section: Managing Sialorrhoeamentioning

confidence: 99%

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Management of oral secretions in neurological disease

McGeachan

McDermott

2017

Pract Neurol

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Sialorrhoea is a common and problematic symptom that arises from a range of neurological conditions associated with bulbar or facial muscle dysfunction. Drooling can significantly affect quality of life due to both physical complications such as oral chapping, and psychological complications such as embarrassment and social isolation. Thicker, tenacious oral and pharyngeal secretions may result from the drying management approach to sialorrhoea. The management of sialorrhoea in neurological diseases depends on the underlying pathology and severity of symptoms. Interventions include anticholinergic drugs, salivary gland-targeted radiotherapy, salivary gland botulinum toxin and surgical approaches. The management of thick secretions involves mainly conservative measures such as pineapple juice as a lytic agent, cough assist, saline nebulisers and suctioning or mucolytic drugs like carbocisteine. Despite a current lack of evidence and variable practice, management of sialorrhoea should form a part of the multidisciplinary approach needed for long-term neurological conditions.

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Section: Managing Sialorrhoeamentioning

confidence: 99%

“…Radiotoxicity can occur resulting in an overly dry mouth with more viscous saliva, facial erythema, pain and nausea 34. These effects are usually short lived and the risk of their development is likely to be reduced with new techniques, such as CT mapping which allows for highly localised therapy 35.…”

Section: Managing Sialorrhoeamentioning

confidence: 99%

Management of oral secretions in neurological disease

McGeachan

McDermott

2017

Pract Neurol

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“…The effectivity of external radiotherapy has been described (in a partially controlled approach [63][64][65][66][67][68][69]) for sialorrhea seen in various neurological diseases. Subsequent to unsuccessful treatment with botulinum toxin, radiation can reduce sialorrhea [70] and, vice versa, post-radiogenic sialorrhea can be reduced by injections of BoNT [71]. This has been demonstrated for additional indications as well, e.g., in the treatment of salivary fistula after parotidectomy [72].…”

Section: External Radiotherapy Of Salivary Glandsmentioning

confidence: 99%

Therapy of Sialorrhea with Botulinum Neurotoxin

et al. 2019

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Botulinum neurotoxin (BoNT) is considered the treatment of choice for various symptoms and diseases such as focal dystonia and focal spasticity. The effects of BoNT on the salivary glands have also been known for years, but their use was limited because of a lack of approval studies. Now the indication of sialorrhea is approved in some countries for incobotulinumtoxinA, such as the USA and Europe, and therapy could also become the treatment of choice. According to the pivotal study, a dose of 100 units of incobotulinumtoxinA, which is divided into the parotid and submandibular glands, is recommended. RimabotulinumtoxinB is approved in the USA only. To define the value of this therapy, we must consider anatomy, physiology, and available therapies. Therapy includes conservative measures such as functional dysphagia therapy, oral or transdermal application of anticholinergics, and, in selected cases, radiotherapy and surgical procedures. A combination of different approaches is optional. On the basis of the evidence and clinical experience, BoNT injections will be the first line of pharmacotherapy for chronic sialorrhea.

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“…Der Nutzen der externen Bestrahlung ist für die Sialorrhoe bei verschiedenen neurologischen Krankheitsbildern beschrieben, z. T. im randomisiert kontrollierten Ansatz [62][63][64][65][66][67][68]. Eine Bestrahlung kann auch nach zuvor erfolgloser Behandlung mit Botulinumtoxin die Hypersalivation mindern [69], und umgekehrt kann eine postradiogene Hypersalivation durch Injektion von Botulinumtoxin reduziert werden [70]. Während die grundsätzliche Wirksamkeit und lange andauernde Wirkung unbestritten sind, so sind die möglichen Nebenwirkungen sowie das zu diskutierende karzinogene Potenzial zu berücksichtigen.…”

Section: Externe Bestrahlung Der Speicheldrüsenunclassified

Therapie der Sialorrhoe mit Botulinumtoxin

Jost

Bäumer

Laskawi

et al. 2019

Fortschr Neurol Psychiatr

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ZusammenfassungDie größten Speicheldrüsen sind die paarigen Gl. parotis und Gl. submandibularis. Der erwachsene Mensch produziert 1–1,5 l Speichel am Tag, die er regelmäßig abschluckt. Die häufigste Ursache eines vermehrten Speichelflusses mit einer Ansammlung von Speichel im Mund und Ausfluss (Sialorrhoe) ist eine Störung der Schluckfunktion. Seltener kann die Ursache auch eine vermehrte Speichelsekretion, z. B. medikamentös bedingt, sein. Eine Sialorrhoe beeinträchtigt die Lebensqualität erheblich und ist oft auch sozial stigmatisierend. Die Therapie umfasst konservative Maßnahmen wir die funktionelle Dysphagietherapie, orale oder transdermale Applikation von Anticholinergika sowie, in ausgewählten Fällen, invasive Therapien wie Bestrahlungen und Operationen. Seit 20 Jahren wird auch die lokale Injektion von Botulinumtoxin in die Speicheldrüsen erfolgreich therapeutisch eingesetzt. Durch die Zulassung dieser Therapie durch die europäische Behörde darf diese Maßnahme als Therapie der Wahl bei ausgeprägter, therapieresistenter Sialorrhoe angesehen werden.

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The role of radiation therapy in the management of sialorrhea: A systematic review

Abstract: EBRT is an effective treatment for sialorrhea in patients suffering from ALS or Parkinson disease. Treatment to the bilateral submandibular glands and caudal parotid glands is the most common field arrangement.

Cited by 41 publications

References 31 publications

Management of oral secretions in neurological disease

Management of oral secretions in neurological disease

Therapy of Sialorrhea with Botulinum Neurotoxin

Therapie der Sialorrhoe mit Botulinumtoxin

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