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

2007 ◽  
Vol 122 (6) ◽  
pp. 609-614 ◽  
Author(s):  
M B Marina ◽  
A Sani ◽  
A H Hamzaini ◽  
B B Hamidon
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Visual Analogue Score ◽  
Rank Test ◽  
Major Salivary Gland ◽  
Ultrasound Guided ◽  
Toxin A ◽  
Signed Rank ◽  
National University ◽  
Signed Rank Test

AbstractDribbling (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.

scholarly journals Efficacy and Safety of Botulinum Toxin A for Treating Bladder Hyperactivity in Children and Adolescents with Neuropathic Bladder Secondary to Myelomeningocele

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Antonio Marte ◽  
Micaela Borrelli ◽  
Maurizio Prezioso ◽  
Lucia Pintozzi ◽  
Pio Parmeggiani
Keyword(s):  
Botulinum Toxin ◽  
Neurogenic Bladder ◽  
Botulinum Toxin A ◽  
Invasive Procedure ◽  
Bladder Capacity ◽  
Rank Test ◽  
Clean Intermittent Catheterization ◽  
Efficacy And Safety ◽  
Average Increase ◽  
Toxin A

We verified the efficacy and safety of botulinum toxin A (BTX-A) in treating bladder overactivity in children with neurogenic bladder (NB) secondary to myelomeningocele (MMC). Forty-seven patients (22, females; 25, males; age range, 5–17 years; mean age, 10.7 years) with poorly compliant/overactive neurogenic bladder on clean intermittent catheterization (CIC) and resistance or noncompliant to anticholinergics were injected with 200 IU of BTX-A intradetrusor. All patients experienced a significant 66.45% average increase of leak point volume (Wilcoxon paired rank test = 7.169 e-10) and a significant 118.57% average increase of specific bladder capacity at 20 cm H2O (Wilcoxon paired rank test = 2.466 e-12). Ten patients who presented with concomitant uni/bilateral grade II–IV vesicoureteral reflux were treated at the same time with Deflux. No patient presented with major perioperative or postoperative problems. Twenty-two patients needed a second and 18 a third injection of BTX-A after 6–9 months for the reappearance of symptoms. After a mean follow-up of 5.7 years, 38 out of 47 patients achieved dryness between CICs, and 9 patients improved their incontinence but still need pads. Our conclusion is that BTX-A represents a viable alternative to more invasive procedure in treatment of overactive NB secondary to MMC.

Ultrasound-guided, intraglandular injection of botulinum toxin A in children suffering from excessive salivation

2007 ◽  
Vol 121 (10) ◽  
pp. 947-951 ◽  
Author(s):  
I Gerlinger ◽  
G Szalai ◽  
K Hollódy ◽  
A Németh
Keyword(s):  
Botulinum Toxin ◽  
Minimally Invasive ◽  
Botulinum Toxin A ◽  
Sympathetic Innervation ◽  
Repeated Treatment ◽  
Ultrasound Guided ◽  
Parasympathetic Innervation ◽  
Toxin A ◽  
Histological Changes ◽  
Excessive Salivation

Background: The aim of this study was to describe the authors' minimally invasive procedure developed to significantly decrease excessive salivation in children suffering from chronic neurological diseases, using botulinum toxin A.Objective: Ultrasound-guided, intraglandular injection of botulinum toxin blocks the parasympathetic innervation of salivary glands, resulting in a temporary decrease in saliva production and improved quality of life, lasting about three to four months.Materials and methods: Prior to introducing the method into clinical practice, animal experiments were conducted in order to verify the lack of histological changes three months following botulinum toxin administration. Twenty-one children were included in the clinical study, with ages ranging from two and a half to 14 years.Results: The animal studies did not reveal any histological changes three months after botulinum toxin administration. Although botulinum toxin A proved to be ineffective in a single case, the majority of the other 20 patients responded well, with a highly significant reduction of their symptoms. The parents of 18 responder children requested repeated treatment with botulinum toxin A. However, two families refused to be further involved in the study, despite good results. The protein content of saliva, regulated by sympathetic innervation, was not affected by the treatment.Conclusion: This minimally invasive method, applied repeatedly three to four times a year, may be a viable alternative to surgical procedures such as submandibular duct relocation, duct ligature or nervus tympanicus neurectomy.

scholarly journals Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea

10.3791/54606 ◽  
2016 ◽  
Author(s):  
Pierangelo Barbero ◽  
Marco Busso ◽  
Carlo Alberto Artusi ◽  
Stefania De Mercanti ◽  
Marco Tinivella ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Ultrasound Guided ◽  
Toxin A
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