Qualitative and quantitative scintigraphy in sialorrhea before and after botulinum toxin injection

Abstract

Objectives/Hypothesis Sialorrhea is excessive saliva production and its usual escape of from the oral cavity. The use of botulinum toxin has been preconized, but its effectiveness until now has been unreliably measured. Our objective was to qualitatively and quantitatively determine the effectiveness of botulinum toxin injection in the reduction of saliva production by the parotid gland. Study Design Outcomes research. Methods Patients with moderate‐to‐critical sialorrhea had one of the parotid glands injected with 50 U of botulinum toxin, leaving the other as the control. Fifteen days after the toxin injection, they underwent scintigraphic analyses with intravenous injection of 10 mCi (37 MBq) of Tc‐99 m (sodium pertechnetate). After this, the noninjected gland was treated for therapeutic complementation. Results The glands injected with botulinum toxin showed uptake reduction in 100% of patients. The uptake reduction in counts per second varied from 8% to 36%. The Wilcoxon paired test comparing the control glands with those injected showed a significant difference for the action of botulinum toxin (P = .0039). Conclusions The scintigraphic study of parotid glands shows that botulinum toxin is effective in reducing sodium pertechnetate uptake. Level of Evidence 2c Laryngoscope, 129:2521–2526, 2019

O uso da Toxina Botulínica tipo A no tratamento de sialorreia em Unidade de Terapia Intensiva: Uma revisão integrativa

“…Para crianças com doença respiratória avançada, pode reduzir a gravidade e o impacto da baba. Ribeiro, et al, 2019. Pesquisa experimental quantitativa e qualitativa O objetivo deste estudo foi determinar qualitativa e quantitativamente a eficácia da injeção de toxina botulínica na redução da produção de saliva através da glândula parótida.…”

“…A eficácia clínica e segurança de injeções de incobotulinumtoxinAm para sialorreia crônica, utilizada em 64 semanas, demostraram uma significativa diminuição de saliva após a terceira ou quarta semana após a injeção (Ribeiro, et al, 2019). O tempo evidenciado pelo autor, para efetividade quanto aos resultados na diminuição de saliva, é um aspecto facilitador para se utilizar toxina como medida protocolar nas UTIs.…”

Impact and management of drooling in children with neurological disorders: an Italian Delphi consensus

“…On the other hand, quantitative scales provide a more reliable evaluation of the severity of drooling but may be difficult in clinical practice [3]. These quantitative scales include Sochaniwskyj's technique, the Drooling Quotient, and gland scintigraphy [19][20][21][22], which uses radioactive isotopes. However, this latter method is quite invasive, and therefore its application in daily practice is largely limited, particularly in pediatrics.…”