A pilot study evaluating the treatment of postparotidectomy sialoceles with botulinum toxin type A

Objective: To report our experience in treating 4 cases of recurrent sialoc eles with botulinum toxin type A after parotid surgery. Design: This is a prospective, nonrandomized, nonblinded pilot study descri bing a new use for botulinum toxin type A. Setting: Tertiary academic medical center. Patients: Four patients (2 men and 2 women) with persistent postparotidecto my sialoceles who had undergone: various: treatment failures were included, The diagnosis was made by fine-needle aspiration of the mass based on well -recognized cytologic features of the entity, as well as an elevated amylas e level and no evidence of tumor or infection. Interventions: Sialoceles were aspirated before local injection of botulinu m toxin type A (30-50 U) subcutaneously. Main Outcome Measures: The patients were followed up 1 week after receiving botulinum toxin type A injection and then at monthly intervals. They were extensively questioned and examined for any evidence of side effects or rec urrence. Results: All patients had to tal resolution of sialocele or external saliva ry fistula within 1 month of treatment. None of the patients to date have d emonstrated recurrences at 7 through 13 months, and there were no complicat ions, particularly facial nerve weakness. Conclusion: Our findings suggest that botulinum toxin type A offers a highl y effective, safe, and noninvasive method of treatment in postparotidectomy sialocele.