Up-to-date report of botulinum toxin therapy in patients with drooling caused by different etiologies
Up-to-date report of botulinum toxin therapy in patients with drooling caused by different etiologies
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DOI：
10.1053/joms.2003.50086
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发表时间：
2003-04-01
影响因子：
1.9
通讯作者：
Arglebe, C
中科院分区：
文献类型：
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作者：
Ellies, M;Laskawi, R;Arglebe, C
目的：在这项研究中，我们评估了各种疾病引起的流涎患者的临床数据，通过注射肉毒毒素A进行治疗。我们还提出了一个控制的后续提示研究记录效率，可能的不良事件，和持续时间的效果treatment.Patients和方法：13例患者流口水所造成的头颈部癌，神经退行性疾病，或中风接受注射50至65 U肉毒杆菌毒素A（肉毒杆菌素，Allergan，欧文，CA）在两个下颌下和两个腮腺超声控制。我们在注射前后的不同时间测量了全唾液流速以及唾液总蛋白、α-淀粉酶、酸性磷酸酶、激肽释放酶和免疫球蛋白A的分析物。患者进行了检查的症状的严重程度，包括头唾液腺的超声调查。结果：所有13例患者报告毒素注射后2周内，他们的症状明显改善。3名患者在12周后出现高流涎率。毒素作用的持续时间在个体之间差异很大。一般来说，唾液流速在注射后1周内急剧下降，但在12周后再次上升。相反，分析物浓度在治疗的第一阶段增加，随后降低，恢复到治疗前水平。超声检查未发现唾液腺实质有任何重大变化，也没有副作用。结论：唾液腺局部注射肉毒杆菌毒素A被证明是治疗各种病因引起的流口水的可靠治疗方法，如13例患者所示。未观察到不良事件。毒素作用持续3个月左右。为了进一步澄清这方面的问题，正在进行长期研究。(C)2003年美国口腔颌面外科医师协会。
Purpose: In this study, we evaluated the clinical data for patients with drooling caused by various diseases, treated by injection of botulinum toxin A. We also present a controlled follow-tip study documenting efficiency, possible adverse events, and duration of the effect of treatment.Patients and Methods: Thirteen patients with drooling caused by head and neck carcinoma, neuro-degenerative diseases, or stroke received injections of 50 to 65 U botulinum toxin A (Botox; Allergan, Irvine, CA) in both submandibular and both parotid glands under sonographic control. We measured whole salivary flow rate and the salivary analytes of total protein, alpha-amylase, acid phosphatase, kallikrein, and immunoglobulin A at various times before and after injection. The patients were examined for severity of symptoms, including sonographic investigation of cephalic salivary glands.Results: All 13 patients reported a distinct improvement of their symptoms within 2 weeks after toxin injection. Three patients noted a return of high salivation rates after 12 weeks. Duration of toxin effect varied widely between individuals. In general, salivary flow rates dropped sharply within 1 week after injection but had risen again after 12 weeks. Conversely, analyte concentrations increased in the first stages of treatment and later decreased, returning to pretherapy levels. Sonography did not reveal any major changes of salivary gland parenchyma, and side effects were absent.Conclusions: Local injection of botulinum toxin A into the salivary glands proved to be a dependable therapy for drooling caused by various etiologies, as shown in 13 patients. Adverse events were not seen. The effect of toxin application lasted for about 3 months. To further clarify this aspect, long-term studies are under way. (C) 2003 American Association of Oral and Maxillofacial Surgeons.