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Ultrasound-guided botulinum toxin A injection: an alternative treatment for dribbling

Published online by Cambridge University Press:  19 July 2007

M B Marina ,
A Sani ,
A H Hamzaini  and
B B Hamidon
M B Marina*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
A Sani
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
A H Hamzaini
Affiliation:
Department of Radiology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
B B Hamidon
Affiliation:
Division of Neurology, Department of Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
*
Address for correspondence: Dr Marina bt Mat Baki, Dept of Otorhinolaryngology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Fax: +603 91737840, E-mail: marinadr72@yahoo.co.uk
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Abstract

Dribbling (sialorrhoea) affects about 10 per cent of patients with chronic neurological disease. The variety of treatments currently available is unsatisfactory. This study was a clinical trial of the efficacy of ultrasound-guided, intraglandular injection of botulinum toxin A for dribbling, performed within the otorhinolaryngology department of the National University of Malaysia. Both pairs of parotid and submandibular glands received 25 U each of botulinum toxin A.

Twenty patients were enrolled in the study. The median age was 15 years. All 20 patients (or their carers) reported a distinct improvement in symptoms after injection. Using the Wilcoxon signed rank test, there were significant reductions in dribbling rating score, dribbling frequency score, dribbling severity score, dribbling visual analogue score and towel changes score, comparing pre- and post-injection states (p<0.001). There were no complications or adverse effects during or after the injection procedure.

Intraglandular, major salivary gland injection of botulinum toxin A is an effective treatment to reduce dribbling. Ultrasound guidance enhances the accuracy of this procedure and minimises the risk of complication.

Keywords

SialorrhoeaBotulinum Toxin Type ASalivary GlandInjectionUltrasonography
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 6 , June 2008 , pp. 609 - 614
Copyright
Copyright © JLO (1984) Limited 2007

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Footnotes

Presented at the Singapore & Malaysia ENT Joint Clinical Meeting, 25 March 2006, National University Hospital, 5 Lower Kent Ridge Road, Singapore, at the 26th Annual General Meeting of the Malaysia ORL-Head and Neck Organisation, 26 May 2006, Langkawi, Malaysia, and at the Asian Oceanian Congress of Radiology, 7 August 2006, Hong Kong, China.

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