ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Intraductal Botulinum Toxin Is Safe for Managing Salivary Disorders

by Amy E. Hamaker • November 10, 2019

  • Tweet
  • Email
Print-Friendly Version

How effective and safe is a single-gland intraductal salivary infusion with onabotulinumtoxinA (BTXA) in the management of salivary disorders?

Bottom Line: The intraductal route of botulinum toxin delivery to salivary glands was without complication and was effective in two patients treated therapeutically. Pressure measurements during infusion may be helpful to direct treatment.

You Might Also Like

  • Botulinum Toxin Injections for ADSD and Chronic Salivary Aspiration
  • Long-Term Botulinum Toxin Management of OMD
  • Does Intraglandular Injection of Botulinum Toxin Improve Pediatric Sialorrhea?
  • Two Techniques Compared for Laryngeal Botulinum Toxin Injection
Explore This Issue
November 2019

Background: Intraglandular injection of botulinum neurotoxin (BTX) is designed to decrease the cholinergic neural stimulus to salivary glands through the process of “chemical
denervation.” Despite limited FDA approval, BTX has been used extensively in salivary disorder management associated with a diverse array of diagnoses in pediatric and adult populations. Intraductal infusion to the salivary glands is performed in the course of conventional sialography, and has the capacity to deliver contrast agents not only to the salivary acini, but also through the acini with what has been termed “parenchymal clouding.”

Study design: Evaluation of two patients using interviews, clinical examination, and pressure measurement during infusion; retrospective chart review of two subsequently treated patients with a parotid-cutaneous fistula and sialorrhea.

Setting: Department of Otolaryngology–Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City.

Synopsis: The two patients assessed showed no complications from 25 units of BTXA infused into the right parotid gland (patient #1) and the left submandibular gland (patient #2). Patient #2 reported that the discomfort experienced in the left submandibular gland as it was expanded in the course of infusion rapidly dissipated by pausing during the otherwise continuous infusion. Following completion of the prospective study of the two initial patients, selected patients were offered intraductal BTXA infusion. Patient #3 was evaluated with a sialogram, which identified the parotid cutaneous fistula with an otherwise normal ductal system without stricture. Initial treatment with ultrasound-guided percutaneous intraglandular injection delivered 50 units of BTXA (in 2.0 cc) to the right parotid gland. The patient reported an initial impression of decreased fistula output that was not realized until one month after the injection. Three and one-half months after percutaneous injection, intraductal infusion to the right parotid gland was performed with BTXA (50 units in 2 cc) followed by 6 cc of saline. Two weeks post-treatment, the patient reported that the result was “95% good.” Patient #4 was initially treated with intraductal infusions of 25 units of BTXA to each submandibular gland followed by infusion of saline (2 cc to right, 3 cc to left). Despite the patient’s subjective lack of benefit, a six-week
follow-up examination revealed only scant saliva expressible from the submandibular glands with massage (previously robust).

Limitations included the retrospective analysis of treatment efficacy limited to only two patients.

Citation: Schwalje AT, Hoffman HT. Intraductal salivary gland infusion with botulinum toxin. Laryngoscope Investig Otolaryngol. 2019;4:520–525.

Filed Under: Head and Neck, Head and Neck, Literature Reviews, Practice Focus Tagged With: salivary disordersIssue: November 2019

You Might Also Like:

  • Botulinum Toxin Injections for ADSD and Chronic Salivary Aspiration
  • Long-Term Botulinum Toxin Management of OMD
  • Does Intraglandular Injection of Botulinum Toxin Improve Pediatric Sialorrhea?
  • Two Techniques Compared for Laryngeal Botulinum Toxin Injection

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Why Virtual Grand Rounds May Be Here to Stay
    • Otolaryngologist Leverages His Love of Pinball into Second Business
    • These New Imaging Advances May Help to Protect Parathyroids
    • Is the Training and Cost of a Fellowship Worth It? Here’s What Otolaryngologists Say
    • Which Otologic Procedures Poses the Greatest Risk of Aerosol Generation?

Polls

Have you used 3D-printed materials in your otolaryngology practice?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.