Treatment of sialorrhoea with ultrasound guided botulinum toxin type A injection in patients with neurological disorders

Objectives-To investigate the safety and efficacy of ultrasound guided botu linum toxin type A (BTX-A) injections into salivary glands for the treatmen t of sialorrhoea in patients with neurological disorders. Methods-The parotid and submandibular glands of 10 patients were injected w ith BTX-A using ultrasound guidance. Before injection, the baseline rate of salivation was assessed using a visual analogue scale. Postinjection, asse ssments were repeated at regular intervals for up to 1 year. Results-Of the 10 patients treated, nine (90%) reported a subjective reduct ion in salivation post-treatment and one patient (10%) found no improvement . Visual analogue scale scores showed a reduction of 55% in the mean rate o f salivation for all patients and a reduction of 60.8% for the group of res ponders. No serious adverse events occurred and no procedure related compli cations were reported. Conclusions-This is the first study to report (1) the injection of BTX-A (B O-TOX(R)) into both parotid and submandibular glands, and (2) the use of ul trasound guidance during the administration of BTX-A into salivary glands. The results suggest that the technique is safe and that BTX-A injections ar e effective for the treatment of sialorrhoea in patients with neurological disorders.