Successful treatment of crocodile tears by injection of botulinum toxin into the lacrimal gland - A case report

Objective: Pathologic lacrimation (crocodile tears) is a rare but stigmatiz ing symptom after facial nerve paralysis. The aim of this pilot study was t o examine whether botulinum toxin injection into the lacrimal gland is effe ctive in reducing pathologic tear secretion. Design: Case report, Intervention: One patient who had crocodile tears after a tester oticus inf ection received a botulinum toxin injection (2.5 mouse units) into the lacr imal gland. Testing: Before injection, 1 week, I month, and 6 months after injection, p atient's lacrimation was assessed by a Schirmer test. Results: The lacrimation of the injected eye was reduced after 1 week and e qual after 1 month when compared to the healthy side. After 6 months, hyper lacrimation reoccurred. No side effects were observed. Conclusion: Intraglandular injection of botulinum toxin into the lacrimal g land may serve as a sufficient therapy for crocodile tears.