Ultrasound-guided submandibular gland injection of botulinum toxin for hypersalivation in cerebral palsy

Sriskandan, N.; Moody, A.B.; Howlett, David

doi:10.1016/j.bjoms.2009.03.005

Cited by 30 publications

(20 citation statements)

References 8 publications

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“…Although the anatomical localization of the submandibular gland for BTX injection study has been reported in previous studies, a comparison of the accuracy of injection into the submandibular gland using US-guided as compared to non-guided techniques has not been reported. The submandibular gland is the major gland responsible for resting saliva secretion; while the parotid gland is predominantly active during mastication [6]. Patients with neurological disorders often suffer from drooling while in the resting state rather than during eating.…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, BTX injection procedures were performed blind using anatomical landmarks or ultrasound (US) guidance [3]. The risks of the procedure include induced weakness of the adjacent muscles, leading to a difficulty in swallowing due to an incorrect injection of the toxin into the masseter or pharyngeal muscles [6]. Other potential risks include hematoma and injury to the carotid arteries or the facial nerve.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of Ultrasound-Guided and Non-ultrasound-Guided Botulinum Toxin Injection Into Cadaver Salivary Glands

Song

Park

et al. 2017

Ann Rehabil Med

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Objective To compare the accuracy of ultrasound (US)-guided and non-US-guided botulinum toxin (BTX) injection into the salivary glands (parotid and submandibular glands) of cadavers. Methods Two rehabilitation physician injected dye into three sites in the salivary glands (two sites in the parotid gland and one site in the submandibular gland) on one side of each cadaver (one was injected on the right side, while the other was injected on the left side), using either a non-US-guided injection procedure based on superficial landmarks or a US-guided procedure. Orange dye was used for the US-guided procedure, and green dye was used for the blind procedure. Two physicians uninvolved with the injection procedures and who were blinded to the method of injection dissected the cadavers to identify whether the dye was accurately injected into each target site. Results The accuracies of the blind and US-guided injections into the parotid gland were 79.17% and 95.83%, respectively. In the submandibular gland, the accuracies of the blind and US-guided injections were 50.00% and 91.67%, respectively. The difference in accuracy between the two procedures was statistically significant only in the submandibular gland (p=0.025). There were no significant differences in the accuracy of US-guided and non-US-guided injections between the two physicians for the two sites in the parotid gland (p=0.278 and p=0.146, respectively). Conclusion US-guided BTX injection into the submandibular gland offers significantly greater accuracy over blind injection. For the treatment of drooling by injecting BTX into the submandibular gland, clinicians should consider using US guidance for improved accuracy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Accuracy of Ultrasound-Guided and Non-ultrasound-Guided Botulinum Toxin Injection Into Cadaver Salivary Glands

Song

Park

et al. 2017

Ann Rehabil Med

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“…The therapeutic application has been extended to various clinical disorders, including salivary secretory diseases [1–5]. In the isolated pathology of one parotid, especially when connected with salivary secretion leakage, the value of the method is even higher than oral antisialogogues and anticholinergic medications that inhibit the total neural stimulation.…”

Section: Discussionmentioning

confidence: 99%

“…Botulinum toxin injection administered during the procedure to decrease the secretion of saliva can improve the healing process. The therapeutic application of botulinum toxin has been extended to various clinical disorders, including salivary secretory diseases [1–5]. In the isolated pathology of one parotid, especially when connected with salivary secretion leakage, the method could be a valuable alternative to oral antisialogogues and anticholinergic medications that inhibit total neural stimulation [6–9].…”

Section: Introductionmentioning

confidence: 99%

Stensen's duct injuries: the role of sialendoscopy and adjuvant botulinum toxin injection.

Kopeć

Wierzbicka²,

Szyfter³

2013

Videosurgery and Other Miniinvasive Techniques

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IntroductionStensen's duct injuries are uncommon but troublesome sequelae of facial surgery or other external traumas.AimTo investigate the feasibility of sialendoscopic control of Stensen's duct in iatrogenic injuries and the efficiency of botulinum toxin adjuvant therapy.Material and methodsIn 2008 and 2010, 5 patients with parotid sialoceles or fistulas, infrequent complications after plastic surgery or trauma, were treated in a single institution, Poznan University of Medical Sciences ENT Department. The group consisted of 5 patients with diagnosed Stensen's duct injuries, which were post-surgery and post-traumatic sequelae. All were treated by means of open surgery. Botulinum toxin injection was administered during the procedure to decrease the saliva secretion and to improve the healing process. A sialendoscopy was performed to control the lumen of the junction after the duct injury was repaired.ResultsComplete healing of the fistulas and sialoceles after the reparative surgery followed by a single botulinum toxin application was observed in all patients within 10-14 days. No side effects were noticed.ConclusionsOur findings suggest that sialendoscopy is a valuable tool and an important step of control in the surgery of parotid duct injuries and the injection of botulinum toxin is an effective and safe second-line treatment.

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“…BTA, an exotoxin produced by Clostridium botulinum , has been described as a means of decreasing saliva production4 due to its anticholinergic effect on the parasympathetic secretomotor fibres of the salivary gland and its use is well recognised in neuromuscular disorders and salivary gland problems 7. There are isolated reports describing its use in post-traumatic salivary fistula where BTA has been either infiltrated around fistula or injected into the gland.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided botulinum toxin injection to treat a parotid fistula following gunshot injury

Gok¹,

Michl

Williams

et al. 2013

J R Army Med Corps

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Parotid fistula is a rare but very distressing sequelum of post-operative or traumatic injuries. The management of these injuries has been reported in the literature previously and techniques employed include pressure dressings, surgery and more recently botulinum toxin A (BTA) injections. We present a patient who developed a parotid fistula as a late complication of an extensive gunshot injury to the face with subsequent successful management with ultrasound-guided intraglandular injections of BTA. This case demonstrates that the BTA injection is an effective and safe method under ultrasound guidance and should considered as a first-line treatment option for the treatment of salivary fistulas.

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Ultrasound-guided submandibular gland injection of botulinum toxin for hypersalivation in cerebral palsy

Cited by 30 publications

References 8 publications

Accuracy of Ultrasound-Guided and Non-ultrasound-Guided Botulinum Toxin Injection Into Cadaver Salivary Glands

Accuracy of Ultrasound-Guided and Non-ultrasound-Guided Botulinum Toxin Injection Into Cadaver Salivary Glands

Stensen's duct injuries: the role of sialendoscopy and adjuvant botulinum toxin injection.

Ultrasound-guided botulinum toxin injection to treat a parotid fistula following gunshot injury

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