Download PDF
Fortschr Neurol Psychiatr 2022; 90(05): 222-232
DOI: 10.1055/a-1802-3867
Übersichtsarbeit

Therapie der Sialorrhoe mit Botulinumtoxin – ein Update

Therapy of Sialorrhea with Botulinum Toxin – An Update
Wolfgang H. Jost 
1   Parkinson-Klinik Ortenau, Wolfach, Germany
,
Tobias Bäumer
2   Institut für Systemische Motorikforschung, CBBM, Sektion Zentrum für Seltene Erkrankungen, UKSH, Universität zu Lübeck, Lübeck, Germany
,
Steffen Berweck
3   Schön Klinik Vogtareuth, Vogtareuth, Germany
4   Dr von Haunersches Kinderspital Kinderklinik und Kinderpoliklinik der Ludwig Maximilian Universitat München, München, Germany
,
Rainer Laskawi
5   Georg-August-Universitat Göttingen HNO-Klinik, Göttingen, Germany
,
Björn Spittau
6   Anatomie und Zellbiologie, Medizinische Fakultät OWL, Universität Bielefeld, Bielefeld, Germany
,
Armin Steffen
7   Universitätsklinikum Schleswig-Holstein Campus Lübeck HNO Klinik, Lübeck, Germany
,
Martin Winterholler
8   Krankenhaus Rummelsberg gGmbH, Schwarzenbruck, Germany
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

Die größten Speicheldrüsen sind die paarigen Gl. parotis und Gl. submandibularis. Der erwachsene Mensch produziert 1–1,5 l Speichel am Tag, die er regelmäßig abschluckt. Die häufigste Ursache eines vermehrten Speichelflusses mit einer Ansammlung von Speichel im Mund und Ausfluss (Sialorrhoe) ist eine Störung der Schluckfunktion. Seltener kann auch eine vermehrte Speichelsekretion, z. B. medikamentös bedingt, die Ursache sein. Eine Sialorrhoe beeinträchtigt die Lebensqualität erheblich und ist oft auch sozial stigmatisierend. Die Therapie umfasst konservative Maßnahmen wie die funktionelle Dysphagietherapie, orale oder transdermale Applikation von Anticholinergika sowie, in ausgewählten Fällen, invasive Therapien wie Bestrahlungen und Operationen. Seit 20 Jahren wird auch die lokale Injektion von Botulinumtoxin in die Speicheldrüsen erfolgreich therapeutisch eingesetzt. Durch die Zulassung von IncobotulinumtoxinA für die Behandlung von Kindern und Erwachsenen darf diese Maßnahme als Therapie der Wahl bei chronischer Sialorrhoe angesehen werden. Die Ergebnisse der Zulassungsstudien zeigen bei Kindern wie auch Erwachsenen eine hohe Effektivität und gute Verträglichkeit der Injektionsbehandlung.

Abstract

The most important salivary glands are the paired parotid and submandibular glands. Adults produce 1 to 1.5 liters of saliva which are then regularly swallowed. When the act of swallowing is disturbed, salivation occurs. More rarely, the cause can be found in increased saliva production, for example, when caused through medication. Sialorrhea impairs the quality of life substantially and is frequently often socially stigmatizing. Therapy includes conservative measures such as functional dysphagia therapy, oral or transdermal application of anticholinergics, as well as, in selected cases, radiation and surgical measures. Over the last 20 years, local injection of botulinum toxin has been successfully applied in the treatment of this condition. With approval of incobotulinumtoxinA toxin for children and adults, this procedure will become the therapy of choice for chronic sialorrhea. The results of the phase III registration trials have demonstrated high efficacy and good safety of the injection treatment in both children and adults.

Schlüsselwörter

Sialorrhoe - Dysphagie - Anticholinergika - Botulinumtoxin

Key words

sialorrhea - dysphagia - anticholinergics - botulinum toxin


Publication History

Received: 04 February 2022

Accepted after revision: 14 March 2022

Article published online:
22 April 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14,70469 Stuttgart, Germany

 

  • Literatur

  • 1 Kochar A, Larian B, Azizzadeh B. Facial nerve and parotid gland anatomy. Consortium on drooling. Otolaryngol Clin North Am 2016; 49: 273-284
    CrossrefPubMedSearch in Google Scholar
  • 2 Pedersen AML, Sörensen CE, Proctor GB. et al. Salivary secretion in health and disease. J Oral Rehabil 2018; 45: 730-746
    CrossrefPubMedSearch in Google Scholar
  • 3 Proctor GB, Carpenter GH. Salivary secretion: Mechanism and neural regulation. Monogr Oral Sci 2014; 24: 14-29
    CrossrefPubMedSearch in Google Scholar
  • 4 Holmberg KV, Hoffman MP. Anatomy, biogenesis and regeneration of salivary glands. Monogr Oral Sci 2014; 24: 1-13
    CrossrefPubMedSearch in Google Scholar
  • 5 Matsuo R. Role of saliva in the maintenance of tast sensitivity. Crit Rev Oral Biol Med 2000; 11: 216-229
    CrossrefPubMedSearch in Google Scholar
  • 6 Tabak LA, Levine MJ, Mandel ID. et al. Role of salivary mucins in the protection of the oral cavity. JCOral Pathol 1982; 11: 1-17
    PubMedSearch in Google Scholar
  • 7 Blasco PA, Allaire JH. Drooling in the developmentally disabled: Management practices and recommendations. Consortium on Drooling. Dev Med Child Neurol 1992; 34: 849-862
    CrossrefPubMedSearch in Google Scholar
  • 8 van Hulst K, van Den Engel-Hoek L, Geurts ACH. et al. Development of the Drooling Infants and Preschoolers Scale (DRIPS) and reference charts for monitoring saliva control in children aged 0–4 years. Infant Behav Dev 2018; 50: 247-256
    CrossrefPubMedSearch in Google Scholar
  • 9 Verma R, Anand KS. Botulinum toxin: A novel therapy for clozapine- induced sialorrhoea. Psychopharmacology (Berl) 2018; 235: 369-371
    CrossrefPubMedSearch in Google Scholar
  • 10 Camp-Bruno JA, Winsberg BG, Green-Parsons AR. et al. Efficacy of benztropine therapy for drooling. Dev Med Child Neurol 1989; 31: 309-319
    CrossrefPubMedSearch in Google Scholar
  • 11 Crysdale WS, White A. Submandibular duct relocation for drooling: A 10-year experience with 194 patients. Otolaryngol Head Neck Surg 1989; 101: 87-92
    CrossrefPubMedSearch in Google Scholar
  • 12 Thomas-Stonell N, Greenberg J. Three treatment approaches and clinical factors in the reduction of drooling. Dysphagia 1988; 3: 73-78
    CrossrefPubMedSearch in Google Scholar
  • 13 Blasco PA. Management of drooling: 10 years after the consortium on drooling, 1990. Dev Med Child Neurol 2002; 44: 778-781
    CrossrefPubMedSearch in Google Scholar
  • 14 Ellies M, Rohrbach-Volland S, Arglebe C. et al. Successful management of drooling with botulinum toxin A in neurologically disabled children. Neuropediatrics 2002; 33: 327-330
    Thieme ConnectPubMedSearch in Google Scholar
  • 15 Crysdale WS, McCann C, Roske L. et al. Saliva control issues in the neu-rologically challenged. A 30 year experience in team management. Int J Pediatr Otorhinolaryngol 2006; 70: 519-527
    CrossrefPubMedSearch in Google Scholar
  • 16 Steffen A, Ortfeld S, Schönweiler R. Drooling bei neuropädiatrischen Patienten – ein Update. Klin Padiatr 2011; 223: 5-9
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Bartolome G. Aspirationsschnelltests und Klinische Schluckuntersuchung. In: Bartolome G, Schröter-Morasch H, eds. Schluckstörungen – Diagnostik und Rehabilitation. 5. Aufl . München: Elsevier; 2014
    CrossrefSearch in Google Scholar
  • 18 Langmore SE, Schatz K, Olsen N. Fiberoptic endoscopic examination of swallowing safety: A new procedure. Dysphagia 1988; 2: 216-219
    CrossrefPubMedSearch in Google Scholar
  • 19 Schröter-Morasch H, Graf S. Dysphagiediagnostik durch den HNO- Arzt. HNO 2014; 62: 324-334
    CrossrefPubMedSearch in Google Scholar
  • 20 Murray J, Langmore SE, Ginsberg S. et al. The significance of accumula-ted oropharyngeal secretions and swallowing frequency in predicting aspiration. Dysphagia 1996; 11: 99-103
    CrossrefPubMedSearch in Google Scholar
  • 21 Reynolds J, Carroll S, Sturdivant C. Fiberoptic endoscopic evaluation of swallowing: A multidisciplinary alternative for assessment of infants with dysphagia in the neonatal intensive care unit. Adv Neonatal Care 2016; 16: 37-43
    CrossrefPubMedSearch in Google Scholar
  • 22 Diesener P. Schluckstörungen bei Kindern: Bildgebende Diagnostik mittels transnasaler Videoendoskopie. Prakt Pädiatrie 1999; 5: 36-42
    PubMedSearch in Google Scholar
  • 23 Bader C, Niemann G. Dysphagie bei Kindern mit Infantiler Zerebralpa rese – Fiberoptisch – Endoskopische Befunde. Laryngorhinootologie 2010; 89: 90-94
    Thieme ConnectPubMedSearch in Google Scholar
  • 24 Rohrbach S, Gross M. Die transnasale fiberoptisch-endoskopische Schluckuntersuchung (FEES) bei Kindern – Standardisiertes diagnostisches Vorgehen. Monatsschr Kinderh 2014; 162: 329-333
    CrossrefPubMedSearch in Google Scholar
  • 25 Holzapfel K. Radiologische Diagnostik von Schluckstörungen. In: Bar-tolome G, Schröter-Morasch H, Hrsg. Schluckstörungen – Diagnostik und Rehabilitation. 5. Aufl . München: Elsevier; 2014
    CrossrefSearch in Google Scholar
  • 26 Olthoff A, Carstens PO, Zhang S. et al. Evaluation of dysphagia by novel real-time MRI. Neurology 2016; 87: 2132-2138
    CrossrefPubMedSearch in Google Scholar
  • 27 Olthoff A, Joseph AA, Weidenmüller M. et al. Real-time MRI of swallo-wing: Intraoral pressure reduction supports larynx elevation. NMR Bio-med 2016; 29: 1618-1623
    CrossrefPubMedSearch in Google Scholar
  • 28 Bartolome G. Grundlagen der funktionellen Dysphagietherapie (FDT). In: Bartolome G, Schröter-Morasch H, Hrsg. Schluckstörungen – Diagnostik und Rehabilitation. München-Jena: Urban & Fischer; 2010: 245-370
    CrossrefSearch in Google Scholar
  • 29 Hinchey JA, Shephard T, Furie K. et al. Formal dysphagia screening pro-tocols prevent pneumonia. Stroke 2005; 36: 1972-1976
    CrossrefPubMedSearch in Google Scholar
  • 30 Carnaby G, Hankey GJ, Pizzi J. Behavioural intervention for dysphagia in acute stroke: A randomised controlled trial. Lancet Neurol 2006; 5: 31-37
    CrossrefPubMedSearch in Google Scholar
  • 31 Prosiegel M, Bartolome G, Biniek R. et al. Rehabilitation neurogener Dysphagien. In: HC D, Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie. Stuttgart: Thieme; 2008: 908-919
    CrossrefSearch in Google Scholar
  • 32 Mikami DLY, Furia CLB, Welker AF. Addition of kinesio taping of the orbicularis oris muscles to speech therapy rapidly improves drooling in children with neurological disorders. Dev Neurorehabil 2017; 21: 1-6
    PubMedSearch in Google Scholar
  • 33 Hussein I, Kershaw AE, Tahmassebi JF. et al. The management of droo ling in children and patients with mental and physical disabilities: A literature review. Int J Paediatr Dent 1998; 8: 3-11
    CrossrefPubMedSearch in Google Scholar
  • 34 Limbrock GJ, Hoyer H, Scheying H. Drooling, chewing and swallowing dysfunctions in children with cerebral palsy: Treatment according to Castillo-Morales. ASDC J Dent Child 1990; 57: 445-451
    PubMedSearch in Google Scholar
  • 35 De Simone GG, Eisenchlas JH, Junin M. et al. Atropine drops for drooling: A randomized controlled trial. Palliat Med 2006; 20: 665-671
    CrossrefPubMedSearch in Google Scholar
  • 36 Hyson HC, Johnson AM, Jog MS. Sublingual atropine for sialorrhea secondary to parkinsonism: A pilot study. Mov Disord 2002; 17: 1318-1320
    CrossrefPubMedSearch in Google Scholar
  • 37 Matos Santana TE, Capurso NA, Ranganathan M. et al. Sublingual atropine in the treatment of clozapine-induced sialorrhea. Schizophr Res 2017; 182: 144-145
    CrossrefPubMedSearch in Google Scholar
  • 38 Fischbacher L, Schröter-Morasch H. Medikamentöse Speichelreduktion bei Neurogener Dysphagie. In: Gross M, Kruse E, Hrsg. Aktuelle phoniatrische-pädaudiologische Aspekte 2003 / 2004. Band 11. Niebüll: Medicombooks.de im Verlag videel; 2003
    CrossrefSearch in Google Scholar
  • 39 Blasco PA, Stansbury JC. Glycopyrrolate treatment of chronic drooling. Arch Pediatr Adolesc Med 1996; 150: 932-935
    CrossrefPubMedSearch in Google Scholar
  • 40 Bachrach SJ, Walter RS, Trzcinski K. Use of glycopyrrolate and other anticholinergic medications for sialorrhea in children with cerebral palsy. Clin Pediatr (Phila) 1998; 37: 485-490
    CrossrefPubMedSearch in Google Scholar
  • 41 Mier RJ, Bachrach SJ, Lakin RC. et al. Treatment of sialorrhea with glycopyrrolate: A double-blind, dose-ranging study. Arch Pediatr Adolesc Med 2000; 154: 1214-1218
    CrossrefPubMedSearch in Google Scholar
  • 42 Man WH, Colen-de Koning JC, Schulte PF. et al. The Effect of glycopyrrolate on nocturnal sialorrhea in patients using clozapine: A randomi zed, crossover, double-blind, placebo-controlled trial. J Clin Psychopharmacol 2017; 37: 155-161
    CrossrefPubMedSearch in Google Scholar
  • 43 Blissit KT, Tillery E, Latham C. et al. Glycopyrrolate for treatment of clozapine-induced sialorrhea in adults. Am J Health Syst Pharm 2014; 71: 1282-1287
    CrossrefPubMedSearch in Google Scholar
  • 44 Lee ZI, Yu KJ, Lee DH. et al. The effect of nebulized glycopyrrolate on posterior drooling in patients with brain injury: Two cases of different brain lesions. Am J Phys Med Rehabil 2017; 96: e155-e158
    CrossrefPubMedSearch in Google Scholar
  • 45 Praharaj SK, Munoli RN, Sharma PS. Low-dose glycopyrrolate for clozapine-associated sialorrhea. J Clin Psychopharmacol 2014; 34: 392
    CrossrefPubMedSearch in Google Scholar
  • 46 Banfi P, Ticozzi N, Lax A. et al. A review of options for treating sialorrhea in amyotrophic lateral sclerosis. Respir Care 2015; 60: 446-454
    CrossrefPubMedSearch in Google Scholar
  • 47 Qurashi I, Chu S, Husain N. et al. Glycopyrrolate in comparison to hyoscine hydrobromide and placebo in the treatment of hypersalivation induced by clozapine (GOTHIC1): Study protocol for a randomised controlled feasibility study. Trials 2016; 17: 553
    CrossrefPubMedSearch in Google Scholar
  • 48 Parr JR, Weldon E, Pennington L. et al. The drooling reduction intervention trial (DRI): A single blind trial comparing the efficacy of glycopyrronium and hyoscine on drooling in children with neurodisability. Trials 2014; 15: 60
    CrossrefPubMedSearch in Google Scholar
  • 49 Zeller RS, Davidson J, Lee HM. et al. Safety and efficacy of glycopyrrolate oral solution for management of pathologic drooling in pediatric patients with cerebral palsy and other neurologic conditions. Ther Clin Risk Manag 2012; 8: 25-32
    CrossrefPubMedSearch in Google Scholar
  • 50 Zeller RS, Lee HM, Cavanaugh PF. et al. Randomized Phase III evaluation of the efficacy and safety of a novel glycopyrrolate oral solution for the management of chronic severe drooling in children with cerebral palsy or other neurologic conditions. Ther Clin Risk Manag 2012; 8: 15-23
    CrossrefPubMedSearch in Google Scholar
  • 51 Uppal HS, De R, D’Souza AR. et al. Bilateral submandibular duct relocation for drooling: An evaluation of results for the Birmingham Children’s Hospital. Eur Arch Otorhinolaryngo 2003; 260: 48-51
    CrossrefPubMedSearch in Google Scholar
  • 52 Katona G, Csákányi Z, Lorincz A. et al. Bilateral submandibular duct relocation by high-frequency radiosurgery. Eur Arch Otorhinolaryngol 2008; 265: 1103-1108
    CrossrefPubMedSearch in Google Scholar
  • 53 Mankarious LA, Bottrill ID, Huchzermeyer PM. et al. Long-term follow- up of submandibular duct rerouting for the treatment of sialorrhea in the pediatric population. Otolaryngol Head Neck Surg 1999; 120: 303-307
    CrossrefPubMedSearch in Google Scholar
  • 54 Martin TJ, Conley SF. Long-term efficacy of intra-oral surgery for sialorrhea. Otolaryngol Head Neck Surg 2007; 137: 54-58
    CrossrefPubMedSearch in Google Scholar
  • 55 Reed J, Mans CK, Brietzke SE. Surgical management of drooling: A meta-analysis. Arch Otolaryngol Head Neck Surg 2009; 135: 924-931
    CrossrefPubMedSearch in Google Scholar
  • 56 Becmeur F, Schneider A, Flaum V. et al. Which surgery for drooling in patients with cerebral palsy?. J Pediatr Surg 2013; 48: 2171-2174
    CrossrefPubMedSearch in Google Scholar
  • 57 Formeister EJ, Dahl JP, Rose AS. Surgical management of chronic sia lorrhea in pediatric patients: 10-year experience from one tertiary care institution. Int J Pediatr Otorhinolaryngol 2014; 78: 1387-1392
    CrossrefPubMedSearch in Google Scholar
  • 58 Noonan K, Prunty S, Ha JF. et al. Surgical management of chronic salivary aspiration. Int J Pediatr Otorhinolaryngol 2014; 78: 2079-2082
    CrossrefPubMedSearch in Google Scholar
  • 59 Kok SE, van der Burg JJ, van Hulst K. et al. The impact of submandibular duct relocation on drooling and the well-being of children with neuro- developmental disabilities. Int J Pediatr Otorhinolaryngol 2016; 88: 173-178
    CrossrefPubMedSearch in Google Scholar
  • 60 Bekkers S, Pruijin IMJ, van der Burg JJW. et al. Surgery versus botulinum neurotoxin A to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial. Dev Med Child Neurol 2021;
    CrossrefPubMedSearch in Google Scholar
  • 61 Feussner H, Schröter-Morasch H. Chirurgische Interventionen bei Schluckstörungen. In: Bartolome G, Schröter-Morasch H, Hrsg. Schluckstörungen – Diagnostik und Rehabilitation. 5. Aufl München: Elsevier; 2014
    CrossrefSearch in Google Scholar
  • 62 Lawson G, Remacle M. Endoscopic cricopharyngeal myotomy: Indications and technique. Curr Opin Otolaryngol Head Neck Surg 2006; 14: 437-441
    CrossrefPubMedSearch in Google Scholar
  • 63 Seegenschmiedt MH, Makoski HB, Trott KR. et al. Sialorrhea / Hypersalivation. In: Seegenschmiedt MH, Makoski HB, Trott KR et al., eds. Radiotherapy for non-malignant disorders. Berlin: Springer; 573-579 2008
    CrossrefSearch in Google Scholar
  • 64 Andersen PM, Grönberg H, Franzen L. et al. External radiation of the parotid glands significantly reduces drooling in patients with motor neurone disease with bulbar paresis. J Neurol Sci 2001; 191: 111-114
    CrossrefPubMedSearch in Google Scholar
  • 65 Borg M, Hirst F. The role of radiation therapy in the management of sialorrhea. Int J Radiat Oncol Biol Phys 1998; 41: 1113-1119
    CrossrefPubMedSearch in Google Scholar
  • 66 Neppelberg E, Haugen DF, Thorsen L. et al. Radiotherapy reduces sia lorrhea in amyotrophic lateral sclerosis. Eur J Neurol 2007; 14: 1373-1377
    CrossrefPubMedSearch in Google Scholar
  • 67 Postma AG, Heesters M, van Laar T. Radiotherapy to the salivary glands as treatment of sialorrhea in patients with parkinsonism. Mov Disord 2007; 22: 2430-2435
    CrossrefPubMedSearch in Google Scholar
  • 68 Assouline A, Levy A, Abdelnour-Mallet M. et al. Radiation therapy for hypersalivation: A prospective study in 50 amyotrophic lateral sclerosis patients. Int J Radiat Oncol Biol Phys 2014; 88: 589-595
    CrossrefPubMedSearch in Google Scholar
  • 69 Weikamp JG, Schinagl DA, Verstappen CC. et al. Botuninum toxin-A injections vs. radiotherapy for drooling in ALS. Acta Neurol Scand 2016; 134: 224-231
    CrossrefPubMedSearch in Google Scholar
  • 70 Hawkey NM, Zaorsky NG, Galloway TJ. The role of radiation therapy in the management of sialorrhea: A systematic review. Laryngoscope 2016; 126: 80-85
    CrossrefPubMedSearch in Google Scholar
  • 71 Steffen A, Wollenberg B, Schönweiler R. et al. Drooling nach Strahlentherapie – Botulinumtoxin als erfolgreiches Therapieverfahren. HNO 2011; 59: 115-117
    CrossrefPubMedSearch in Google Scholar
  • 72 Xu H, Shan XF, Cong X. et al. Pre- and post-synaptic effects of botulinum toxin A on submandibular glands. J Dent Res 2015; 94: 1454-1462
    CrossrefPubMedSearch in Google Scholar
  • 73 Rossetto O, Pirazzini M, Fabris F, Montecucco C. Botulinum Neurotoxins: Mechanism of Action. Handb Exp Pharmacol 2021; 263: 45-47
    CrossrefPubMedSearch in Google Scholar
  • 74 Bhatia KP, Münchau A, Brown P. Botulinum toxin is a useful treatment in excessive drooling in saliva. J Neurol Neurosurg Psychiatry 1999; 67: 697
    CrossrefPubMedSearch in Google Scholar
  • 75 Bushara KO. Sialorrhea in amyotrophic lateral sclerosis: A hypothesis of a new treatment – Botulinum toxin A injections of the parotid glands. Med Hypotheses 1997; 48: 337-339
    CrossrefPubMedSearch in Google Scholar
  • 76 Jost WH. Treatment of drooling in Parkinson’s disease with botulinum toxin. Mov Disord 1999; 14: 1057
    CrossrefPubMedSearch in Google Scholar
  • 77 Jost WH, Friedman A, Michel O. et al. SIAXI: Placebo-controlled, randomized, double-blind study of incobotulinumtoxinA for sialorrhea. Neurology 2019; 92: e1982-e1991
    CrossrefPubMedSearch in Google Scholar
  • 78 Jost WH, Friedman A, Michel O. et al. Long-term incobotulinumtoxinA treatment for chronic sialorrhea: Efficacy and safety over 64 weeks. Parkinsonism Relat Disord 2020;
    CrossrefPubMedSearch in Google Scholar
  • 79 Berweck S, Bonikowski M, Kim H. et al. Placebo-controlled clinical trial of incobotulinumtoxinA for sialorrhea in children: SIPEXI. Neurology 2021;
    CrossrefPubMedSearch in Google Scholar
  • 80 Chaléat-Valayer E, Porte M, Buchet-Poyau K. et al. Management of drooling in children with cerebral palsy: A French survey. Eur J Paediatr Neurol 2016; 20: 524-531
    CrossrefPubMedSearch in Google Scholar
  • 81 Dashtipour K, Bhidayasiri R, Chen JJ. et al. RimabotulinumtoxinB in sialorrhea: Systematic review of clinical trials. J Clin Mov Disord 2017; 4: 9
    CrossrefPubMedSearch in Google Scholar
  • 82 Dogu O, Apaydin D, Sevim S. et al. Ultrasound-guided versus ‘blind’ intraparotid injections of botulinum toxin-A for the treatment of sia lorrhoea in patients with Parkinson’s disease. Clin Neurol Neurosurg 2004; 106: 93-96
    CrossrefPubMedSearch in Google Scholar
  • 83 Egevad G, Petkova VY, Vilholm OJ. Sialorrhea in patients with Parkinson’s disease: Safety and administration of botulinum neurotoxin. J Parkinsons Dis 2014; 4: 321-326
    CrossrefPubMedSearch in Google Scholar
  • 84 Mazlan M, Rajasegaran S, Engkasan JP. et al. A double-blind randomized controlled trial investigating the most efficacious dose of botulinum toxin-A for sialorrhea. Treatment in asian adults with neurological diseases. Toxins (Basel) 2015; 7: 3758-3770
    CrossrefPubMedSearch in Google Scholar
  • 85 Ko SH, Shin YB, Min JH. et al. Botulinum toxin in the treatment of drooling in tetraplegic patients with brain injury. Ann Rehabil Med 2013; 37: 796-803
    CrossrefPubMedSearch in Google Scholar
  • 86 Mancini F, Zangaglia R, Cristina S. et al. Double-blind, placebo-controlled study to evaluate the efficacy and safety of botulinum toxin type A in the treatment of drooling in parkinsonism. Mov Disord 2003; 18: 685-688
    CrossrefPubMedSearch in Google Scholar
  • 87 Martínez-Poles J, Nedkova-Hristova V, Escribano-Paredes JB. et al. Inco- botulinumtoxin A for sialorrhea in neurological disorders: A real-life experience. Toxins (Basel) 2018; 10 pii E217
    CrossrefPubMedSearch in Google Scholar
  • 88 Narayanaswami P, Geisbush T, Tarulli A. et al. Drooling in Parkinson’s disease: A randomized controlled trial of incobotulinum toxin A and meta-analysis of Botulinum toxins. Parkinsonism Relat Disord 2016; 30: 73-77
    CrossrefPubMedSearch in Google Scholar
  • 89 Issacson SH, Ondo W, Jackson CE. et al. Safety and efficacy of rimabotulinumtoxinB for treatment of sialorrhea in adults: a randomized clinical trial. JAMA Neurol 2020;
    CrossrefPubMedSearch in Google Scholar
  • 90 Restivo DA, Panebianco M, Casabona A. et al. Botulinum toxin A for sialorrhoea associated with neurological disorders: Evaluation of the relationship between effect of treatment and the number of glands treated. Toxins (Basel) 2018; 10 pii E55
    CrossrefPubMedSearch in Google Scholar
  • 91 Stokholm MG, Bisgård C, Vilholm OJ. Safety and administration of treatment with botulinum neurotoxin for sialorrhoea in ALS patients: Review of the literature and a proposal for tailored treatment. Amyotroph Lateral Scler Frontotemporal Degener 2013; 14: 516-520
    CrossrefPubMedSearch in Google Scholar
  • 92 Giess R, Naumann M, Werner E. et al. Injections of botulinum toxin A into the salivary glands improve sialorrhoea in amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2000; 69: 121-123
    CrossrefPubMedSearch in Google Scholar
  • 93 George KS, Kiani H, Witherow H. Effectiveness of botulinum toxin B in the treatment of drooling. Br J Oral Maxillofac Surg 2013; 51: 783-785
    CrossrefPubMedSearch in Google Scholar
  • 94 Ondo WG, Hunter C, Moore W. A double-blind placebo-controlled trial of botulinum toxin B for sialorrhea in Parkinson’s disease. Neurology 2004; 62: 37-40
    CrossrefPubMedSearch in Google Scholar
  • 95 Winterholler MG, Erbguth FJ, Wolf S. et al. Botulinum toxin for the treatment of sialorrhoea in ALS: Serious side effects of a transductal approach. J Neurol Neurosurg Psychiatry 2001; 70: 417-418
    CrossrefPubMedSearch in Google Scholar
  • 96 Steffen A, Jost W, Bäumer T. et al. Hypersalivation: Update of the German S2k guideline (AWMF) in short form. J Neural Transm (Vienna) 2019;
    CrossrefPubMedSearch in Google Scholar
  • 97 Scott J. Age, sex and contralateral differences in the volumes of human submandibular salivary glands. Arch Oral Biol 1975; 20: 885-887
    CrossrefPubMedSearch in Google Scholar
  • 98 Ono K, Morimoto Y, Inoue H. et al. Relationship of the unstimulated whole saliva flow rate and salivary gland size estimated by magnetic resonance image in healthy young humans. Arch Oral Biol 2006; 51: 345-349
    CrossrefPubMedSearch in Google Scholar
  • 99 So JI, Song DH, Park JH. et al. Accuracy of ultrasound-guided and non- ultrasound-guided botulinum toxin injection into cadaver salivary glands. Ann Rehab Med 2017; 41: 51-57
    CrossrefPubMedSearch in Google Scholar
  • 100 Loens S, Bruggemann N, Steffen A. et al. Localization of salivary glands for botulinum toxin treatment: ultrasound versus landmark guidance. Mov Disord Clin Pract 2020; 7: 194-198
    CrossrefPubMedSearch in Google Scholar
  • 101 McGeachan AJ, McDermott CJ. Management of oral secretions in neu rological disease. Pract Neurol 2017; 17: 96-103
    CrossrefPubMedSearch in Google Scholar
  • 102 Jost WH. The option of sonographic guidance in botulinum toxin injection for drooling in Parkinson’s disease. J Neural Transm 2016; 123: 51-55
    CrossrefPubMedSearch in Google Scholar
  • 103 Chinnapongse R, Gullo K, Nemeth P. et al. Safety and efficacy of botulinum toxin type B for treatment of sialorrhea in Parkinson’s disease: A prospective double-blind trial. Mov Disord 2012; 27: 219-226
    CrossrefPubMedSearch in Google Scholar
  • 104 Guidubaldi A, Fasano A, Ialongo T. et al. Botulinum toxin A versus B in sialorrhea: A prospective, randomized, double-blind, crossover pilot study in patients with amyotrophic lateral sclerosis or Parkinson’s disease. Mov Disord 2011; 26: 313-319
    CrossrefPubMedSearch in Google Scholar
  • 105 Jackson CE, Gronseth G, Rosenfeld J. et al. Randomized double-blind study of botulinum toxin type B for sialorrhea in ALS patients. Muscle Nerve 2009; 39: 137-143
    CrossrefPubMedSearch in Google Scholar
  • 106 Lagalla G, Millevolte M, Capecci M. et al. Botulinum toxin type a for drooling in Parkinson’s disease: A double-blind, randomized, placebo-controlled study. Mov Disord 2006; 5: 704-707
    CrossrefPubMedSearch in Google Scholar
  • 107 Lagalla G, Millevolte M, Capecci M. et al. Long-lasting benefits of botulinum toxin type B in Parkinson’s disease-related drooling. J Neurol 2009; 256: 563-567
    CrossrefPubMedSearch in Google Scholar
  • 108 Lipp A, Trottenberg T, Schink T. et al. A randomized trial of botulinum toxin A for treatment of drooling. Neurology 2003; 61: 1279-1281
    CrossrefPubMedSearch in Google Scholar
  • 109 Reid SM, Johnstone BR, Westbury C. et al. Randomized trial of botulinum toxin injections into the salivary glands to reduce drooling in children with neurological disorders. Dev Med Child Neurol 2008; 50: 123-128
    CrossrefPubMedSearch in Google Scholar
  • 110 Steinlechner S, Klein C, Moser A. et al. Botulinum toxin B as an effective and safe treatment for neuroleptic-induced sialorrhea. Psychopharmacology (Berl) 2010; 207: 593-597
    CrossrefPubMedSearch in Google Scholar
  • 111 Piccillo EM, Adkins D, Elrakhawy M, Carr MM. Cricopharyngeal Myotomy in National Surgical Quality Improvement Program (NSQIP). Complications for Otolaryngologists Versus Non-otolaryngologists. Cureus 2021; 13: e19021
    PubMedSearch in Google Scholar
  • 112 Wu PI, Szczesniak MM, Omari T. et al. Cricopharyngeal peroral endoscopic myotomy improves oropharyngeal dysphagia in patients with Parkinsonʼs disease. Endosc Int Open 2021; 9: E1811-E1819
    Thieme ConnectPubMedSearch in Google Scholar