Therapy of Sialorrhea with Botulinum Neurotoxin

Jost, Wolfgang H.; Bäumer, Tobias; Laskawi, R.; Sławek, Jarosław; Spittau, Björn; Steffen, Armin; Winterholler, Martin; Bavikatte, Ganesh

doi:10.1007/s40120-019-00155-6

Cited by 39 publications

(39 citation statements)

References 103 publications

(115 reference statements)

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“…They include dry mouth, diarrhea, neck pain, and dysphagia. BoNT is currently considered as the most effective agent for treating chronic sialorrhea [23] , [24] .…”

Section: Hypothesis and Discussionmentioning

confidence: 99%

Pharmacotherapy for reducing saliva and droplet production in airborne procedures may help to decrease the COVID-19 transmission: A hypothesis

et al. 2020

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The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected health care service practices worldwide. Therefore, a global reaction to prepare health care systems is mandatory. Preventing the transmission of this virus during medical and dental procedures producing airborne particles and droplets, could be considered as one of the main venues in prevention of Coronavirus disease 2019 (COVID-19) transmission in health care facilities. To the best of our knowledge, no intervention has been approved for this purpose, so the major suggestion in this regard is using personal preventive equipment (PPE) and similar measures as well as other sanitizing practices. Since we do not know how long we should face this universal issue, using antecedent pharmacotherapies for reducing oral-respiratory secretions to combat this virus might play a role in this regard. Given that currently there is no definitive cure for COVID-19, so we hypothesize that, considering drug solutions to reduce saliva and droplet production may be helpful in controlling Coronavirus spread during aerosol and respiratory droplet producing procedures.

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“…They include dry mouth, diarrhea, neck pain, and dysphagia. BoNT is currently considered as the most effective agent for treating chronic sialorrhea [23] , [24] .…”

Section: Hypothesis and Discussionmentioning

confidence: 99%

Pharmacotherapy for reducing saliva and droplet production in airborne procedures may help to decrease the COVID-19 transmission: A hypothesis

et al. 2020

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“…The most important indication for BoNT in PS is sialorrhea, or drooling [ 18 ]. PD patients do not actively produce more saliva, instead they fail to swallow their saliva sufficiently (impaired oropharyngeal swallowing.…”

Section: Approved Resp Licensed Indicationsmentioning

confidence: 99%

“…PD patients do not actively produce more saliva, instead they fail to swallow their saliva sufficiently (impaired oropharyngeal swallowing. inadequate clearance, with anterior and posterior pooling), for which reason saliva is repeatedly released [ 18 ]. This is reinforced through forward head posture as well as incomplete mouth closure.…”

Section: Approved Resp Licensed Indicationsmentioning

confidence: 99%

“…This is reinforced through forward head posture as well as incomplete mouth closure. Medication for reducing saliva production typically has systemic side effects [ 18 ]. For a number of years, BoNT/A and BoNT/B have proven useful here.…”

Section: Approved Resp Licensed Indicationsmentioning

confidence: 99%

“…For a number of years, BoNT/A and BoNT/B have proven useful here. At present, there is qualitative data for abo-, inco-, onaBoNT/A, and rimaBoNT/B [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ].…”

Section: Approved Resp Licensed Indicationsmentioning

confidence: 99%

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Use of Botulinum Neurotoxin in Parkinson’s Disease: A Critical Appraisal

Jost

2021

Toxins

Self Cite

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For well over 30 years, the botulinum neurotoxin (BoNT) has been used for a large number of indications, some of which however have not been licensed. Admittedly, approval varies in many countries and this permits a large spectrum for evaluation. Thus, BoNT is used for patients with Parkinson’s disease (PD) and other Parkinson’s syndromes (PS) in varying degrees of frequency. We have to distinguish between (1) indications that are either approved or (2) those not approved, (3) indications that might be a result of PS and (4) finally those which appear independent of PS. The most important indication for BoNT in PS patients is probably sialorrhea, for which approval has been granted in the majority of countries. Cervical dystonia is a frequent symptom in PS, with anterocollis as a specific entity. A further indication is blepharospasm in the different forms, especially the inhibition of eyelid opening in atypical PS. The use of BoNT in cases of camptocormia, the Pisa syndrome and neck rigidity is still a matter of debate. In dystonia of the extremities BoNT can be recommended, especially in dystonia of the feet. One well-known indication, for which however sufficient data are still lacking, involves treating tremor with BoNT. As to autonomic symptoms: Focal hyperhidrosis and detrusor hyperactivity can be mentioned, in this last case BoNT has already been approved. A number of further but rare indications such as freezing-of-gait, dyskinesia, and dysphagia will be discussed and evaluated.

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Botulinum toxin in the treatment of sialorrhea in severe neurological patients with tracheotomy

Shao

Chen

et al. 2023

Brain and Behavior

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ObjectiveTo observe the clinical effect of botulinum toxin type A (BTA) injection into the salivary glands of the severe neurological patients with tracheotomyMethodsSeven patients with severe neurological disorders after tracheotomy and obvious drooling symptoms were enrolled. BTA was injected into bilateral parotid glands and submandibular glands under the guidance of ultrasound. Unstimulated salivary flow rate (uSFR) and Drooling Severity and Frequency Scale (DSFS) were used to evaluate drooling before injection, 1 week, and 4 weeks after injection. We compared the extubation time, time of changing from balloon cannula to metal cannula, hospitalization time and incidence of recurrent pulmonary infection between these patients and other patients accepted conventional curation.Results(1) The drooling severity scale (DSFS‐S), the drooling frequency scale (DSFS‐F), the drooling frequency and severity scale total score (DSFS‐T) were significantly lower at 4 weeks after BTA injection compared to prior‐treatment (p < .001). (2) uSFR of 1 week and 4 weeks were both statistically decreased than the untreated condition (p < .001). (3) Compared with the conventional group, the time of changing from balloon cannula to metal cannula was shortened obviously (p < .05) and incidence of recurrent pulmonary infection was clearly decreased (p < .05) after BTA treatmentConclusionUltrasound‐guided BTA injection into salivary glands can effectively reduce saliva secretion. We also found that the time of changing cannula was shortened obviously and the incidence of recurrent pneumonia infection was reduced. BTA injection of salivary glands to cure drooling could advance to the clinical therapy in severe neurological patients after tracheotomy.

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Therapy of Sialorrhea with Botulinum Neurotoxin

Cited by 39 publications

References 103 publications

Pharmacotherapy for reducing saliva and droplet production in airborne procedures may help to decrease the COVID-19 transmission: A hypothesis

Pharmacotherapy for reducing saliva and droplet production in airborne procedures may help to decrease the COVID-19 transmission: A hypothesis

Use of Botulinum Neurotoxin in Parkinson’s Disease: A Critical Appraisal

Botulinum toxin in the treatment of sialorrhea in severe neurological patients with tracheotomy

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