Adjuvant Role of Botulinum Toxin A in the Management of Wounds Accompanied by Parotid Gland or Duct Injuries

Background: Parotid gland or duct injuries may occur after facial trauma or surgical procedures around the parotid gland. Such injuries often cause saliva to leak into the wound, and as a result, the autolytic enzymes in the saliva can delay wound healing. To promote wound healing in such cases, salivary leakage must be stopped until the wound has completely healed. Though there are several known measures for preventing salivary leakage, including compressive dressings, suction drainage, food restriction, and anticholinergic drugs, they often yield unsatisfactory results. This study aimed to evaluate the clinical efficacy of botulinum toxin A in stopping salivary secretions and inducing wound healing in wounds accompanied by parotid gland or duct injuries.<br/>Methods: A retrospective study was conducted to evaluate the efficacy of botulinum toxin A for treating salivary leakage due to parotid gland or duct injuries. Five patients were treated between 2011 and 2016, three of whom received postoperative injections with a total dose of 30–40 units of botulinum toxin A. One of the other two patients was injected with the same amount of botulinum toxin A preoperatively, and the other received an intraoperative injection.<br/>Results: All five patients showed an abrupt decrease of salivary leakage on the 3rd day after toxin injection and satisfactory wound healing without untoward side effects.<br/>Conclusion: This study demonstrates the critical role played by botulinum toxin A in management of wounds complicated by abnormal leakage of saliva, when the parotid gland or duct is injured.

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Botulinum Toxin-A to Improve Urethral Wound Healing: An Experimental Study in a Rat Model

Urology ◽

10.1016/j.urology.2008.07.051 ◽

2009 ◽

Vol 73 (2) ◽

pp. 405-409 ◽

Cited By ~ 18

Author(s):

Tayfun Sahinkanat ◽

Keramettin Ugur Ozkan ◽

Harun Cıralık ◽

Senol Ozturk ◽

Sefa Resim

Keyword(s):

Experimental Study ◽

Wound Healing ◽

Botulinum Toxin ◽

Rat Model ◽

Botulinum Toxin A ◽

Toxin A

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S148 – Botulinum Toxin A for the Management of Gustatory Sweating

Otolaryngology ◽

10.1016/j.otohns.2008.05.321 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P126-P126 ◽

Cited By ~ 1

Author(s):

Purushotam Sen ◽

Michael Papesch

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin A ◽

The Other ◽

Cochrane Library ◽

Safe Procedure ◽

Frey’S Syndrome ◽

Toxin A ◽

Duration Of Symptoms ◽

Gustatory Sweating ◽

Frey's Syndrome

Objectives To review systematically the evidence currently available on the use of botulinum toxin A in the management of gustatory sweating. Methods We conducted a systematic search of databases including PubMed (1950-December 2007), EMBASE (1966–2007), MEDLINE (1950–2007) and Cochrane library (up to December 2007). The terms used in the search included treatment, Frey's syndrome, gustatory sweating, Botulinum toxin, Botox, Dysport. Data extraction and study evaluation were performed independently by 2 reviewers and results were pooled quantitatively. Data collected included demographic details of patients, aetiology of Frey's syndrome (parotid pathology), duration of symptoms, units of injection, number of injections, commercial types of Botulinum toxin A, rate of recurrence, complications, and length of follow-up. Results There are 2 prospective studies that compared doses of Botulinum toxin (one randomized and the other non-randomized) in the management of gustatory sweating (Frey's syndrome). The other studies included prospective and retrospective case series and case reports. Pooled results from these studies on a total of 239 patients showed that the rate of recurrence or incomplete resolution of symptoms were dose-dependent. Response to treatment did not vary with the size of the affected area or parotid pathology. The demographical details did not differ in the patients with recurrence compared to those patients who were symptom-free. Complications were also not dose-related. Conclusions Botulinum toxin A is a highly effective, minimally invasive, and safe procedure for the treatment of gustatory sweating.

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Botulinum toxin therapy for nonneurogenic overactive bladder: first experience

Acta medica Lituanica ◽

10.6001/actamedica.v18i3.1825 ◽

2011 ◽

Vol 18 (3) ◽

pp. 120-126

Author(s):

Aušra ČERNIAUSKIENĖ ◽

Feliksas JANKEVIČIUS

Keyword(s):

Botulinum Toxin ◽

Overactive Bladder ◽

Botulinum Toxin A ◽

Urine Volume ◽

Bladder Capacity ◽

Anticholinergic Drugs ◽

Detrusor Muscle ◽

Residual Urine Volume ◽

Toxin A

The paper presents early experience in the treatment of 20 patients with botulinum toxin injections into the detrusor muscle for the treatment of non-neurogenic overactive bladder (OAB) resistant to anticholinergic drugs. Background. Botulinum toxin, a presynaptic neuromuscular blocking agent, reduces the involuntary bladder contractions that cause urgency, frequency and urge incontinence. We present our early experience with Dysport® injections into the detrusor for the treatment of non–neurogenic overactive bladder (OAB) resistant to anticholinergic drugs. Materials and methods. Using intravenous anaesthesia, 20 patients (18 female and 2 male) with non-neurogenic OAB were injected with botulinum toxin A (Dysport®250 IU diluted in 4 ml normal saline) under cystoscopic visualization in 20 sites in the detrusor muscle, sparing the trigone. The urethral catheter was removed 24 hours after the procedure. Follow-up at 3 and 6 months after the injection included the Urogenital Distress Inventory UDI-6, the Incontinence Impact Questionnaire IIQ-7, clinical parameters and ultrasound measurement of bladder capacity and post-void residual urine volume. Results. All 20 patients completed questionnaires and were examined after 3 and 6 months. At the 3-month follow-up, the median daytime micturation frequency decreased from 10.4 to 4.6 times (p < 0.0001) and at the 6 months follow-up 5 times (p < 0.0001), while nocturia decreased from 4.2 to 1.3 times after 3 months (p < 0.0001) and after 6 months to 2 times (p < 0.0001). Urgency decreased from 6 to 1.5 times after 3 months (p < 0.0001) and to 2 times after 6 months (p < 0.0001), and incontinence decreased from 4.2 times to 1.5 times after 3 months (p < 0.0001) and to 2.1 times after 6 months (p < 0.0001). The median maximum bladder capacity increased from 250 to 420 ml after 3 months (p < 0.0001) and decreased to 350 ml after 6 months (p < 0.0001). The post-void median residual urine volume was 10 ml. Only one patient mentioned a post-operative obstructive voiding difficulty. Eighteen (90%) patients were satisfied with the treatment. In two patients (10%), the amelioration of symptoms lasted for one month only, and later OAB symptoms reappeared. Analysis of the UDI-6 and IIQ-7 questionnaires revealed that botulinum toxin A intradetrusor injection had decreased discomfort for patients and ameliorated their quality of life. Conclusions. Botulinum toxin A injections in the detrusor are effective for the treatment of non-neurogenic OAB. Botulinum toxin A injections are a minimally invasive therapy and offer an alternative treatment for non–neurogenic OAB dysfunction resistant to conservative treatment. The durability of the treatment effect is the objective of the further investigation. Keywords: botulinum toxin, overactive bladder, urinary incontinence

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