20 research outputs found
Quantitative reduction of saliva production in two ALS patients with intraglandular injections of botulinum toxin.
No full textA quantitative reduction of saliva production to less than 10% of original flow rate could be achieved by intraglandular injections of a total of 300 units of botulinum toxin (type DysportR) in two amyotrophic lateral sclerosis (ALS) patients. The treatment effect lasted for at least 8 weeks and increased after repeated injections. All major salivary glands were injected. Masseter strength did not decrease intolerably. This treatment can therefore be recommended even in ALS patients with paresis of the bulbar musculature
Quantitative reduction of saliva production in two ALS patients with intraglandular injections of botulinum toxin.
No full textA quantitative reduction of saliva production to less than 10% of original flow rate could be achieved by intraglandular injections of a total of 300 units of botulinum toxin (type DysportR) in two amyotrophic lateral sclerosis (ALS) patients. The treatment effect lasted for at least 8 weeks and increased after repeated injections. All major salivary glands were injected. Masseter strength did not decrease intolerably. This treatment can therefore be recommended even in ALS patients with paresis of the bulbar musculature
Tumors of the salivary glands in childhood and adolescence
No full textPurpose: We report on 52 juvenile and adolescent patients with benign and malignant tumors of the salivary glands. Controlled follow-up was carried out to examine outcome and side effects of therapy. Patients and Methods: The clinical files of 52 patients were evaluated by computer-based methods. Follow-up was comprised of the findings of our clinic as well as those of the primarily consulted physicians and, if possible, up-to-date examinations in our clinic. Results: Benign tumors had their highest incidence in puberty and postpuberty. Forty patients (20 girls and 20 boys; 77%) had benign growths and 12 patients (9 girls and 3 boys; 23%) suffered from malignant neoplasms. After surgery for benign tumors we saw no postoperative recurrences in long-term follow-up. In the group of malignant tumors, 8 patients (66.7%) survived their disease in the long-term follow-up. Conclusions: Salivary gland diseases are rare in childhood and adolescence. Their pattern of incidence differs very much from that of adults. This is particularly true for the malignant parotid tumors that are more frequent in juvenile patients, a fact that has to be considered in diagnosis and therapy. (C) 2006 American Association of Oral and Maxillofacial Surgeons
Inflammatory diseases of the salivary glands in infants and adolescents
No full textObjective: To determine retrospectively the localization, etiology and treatment of inflammatory diseases of the salivary glands in infants and children and to evaluate treatment outcome. Patients and methods: Forty-five patients were treated in our institution in the period 1966-2000. The patients' records were evatuated and the results and side-effects of therapy were documented by a controlled follow-up study. Results: Twenty-five of our patients were females (55.6%) and 20 mates (44.4%). Inflammatory disorders figured most prominently in the group of patients between 12 and 16 years (n = 14). Inflammation of the submandibular glands was the most common disease with 53.3% (n = 24). The most frequent underlying cause in this subgroup of acute and chronic siatadenitis was sialolithiasis of the submandibular gland (40%). All patients were symptom-free in the tong-term follow-up and all were symptom-free after surgical intervention. Conclusions: The present study shows that diseases of the salivary glands are rare among infants and children. Acute and chronic sialadenitis not responding to conservative treatment requires an appropriate surgical approach. (c) 2005 Elsevier Ireland Ltd. All rights reserved
Up-to-date report of botulinum toxin therapy in patients with drooling caused by different etiologies
No full textPurpose: In this study, we evaluated the clinical data for patients with drooling caused by various diseases, treated by injection of botulinum toxin A. We also present a controlled follow-tip study documenting efficiency, possible adverse events, and duration of the effect of treatment. Patients and Methods: Thirteen patients with drooling caused by head and neck carcinoma, neuro-degenerative diseases, or stroke received injections of 50 to 65 U botulinum toxin A (Botox; Allergan, Irvine, CA) in both submandibular and both parotid glands under sonographic control. We measured whole salivary flow rate and the salivary analytes of total protein, alpha-amylase, acid phosphatase, kallikrein, and immunoglobulin A at various times before and after injection. The patients were examined for severity of symptoms, including sonographic investigation of cephalic salivary glands. Results: All 13 patients reported a distinct improvement of their symptoms within 2 weeks after toxin injection. Three patients noted a return of high salivation rates after 12 weeks. Duration of toxin effect varied widely between individuals. In general, salivary flow rates dropped sharply within 1 week after injection but had risen again after 12 weeks. Conversely, analyte concentrations increased in the first stages of treatment and later decreased, returning to pretherapy levels. Sonography did not reveal any major changes of salivary gland parenchyma, and side effects were absent. Conclusions: Local injection of botulinum toxin A into the salivary glands proved to be a dependable therapy for drooling caused by various etiologies, as shown in 13 patients. Adverse events were not seen. The effect of toxin application lasted for about 3 months. To further clarify this aspect, long-term studies are under way. (C) 2003 American Association of Oral and Maxillofacial Surgeons
Successful Management of Drooling with Botulinum Toxin A in Neurologically Disabled Children
No full textObjectives: The present study investigates the effect of topical injections of botulinum toxin A into the cephalic salivary glands of children with chronic hypersalivation due to neurodegenerative diseases. Methods: Five children with hypersalivation due to severe neurological diseases received, under ultrasound guidance, a total of 50 - 65 units of botulinum toxin A (Botox((R))) into the parotid and submandibular glands on both sides. All injections were tolerated without local anaesthesia. Before and 1, 2, 4, 8 and 12 weeks after toxin injection, salivary flow rates and the concentrations of total protein, alpha-amylase, acid phosphatase, kallikrein, and immunoglobulin A were measured in the secretions; simultaneously, the patients were clinically examined with regard to severity of symptoms, and their salivary glands were subjected to ultrasound study. Results: A distinct improvement of symptoms within the first 2 weeks following toxin administration were reported by the parents. Sialometry revealed considerably reduced flow rates but sialochemistry showed an increase of amylase activity. Ultrasound examination did not reveal any changes of the salivary parenchyma, and side-effects were absent. Conclusions: Treatment of drooling by topical injection of botulinum toxin A into the salivary glands is a reliable and also side-effect-free therapeutic option for children with neurological disorders. All children involved in our study experienced a distinct improvement of their quality of life
Reduction of salivary flow with botulinum toxin: Extended report on 33 patients with drooling, salivary fistulas, and sialadenitis
No full textObjectives/Hypothesis. The aim of the study was the evaluation of the clinical data of 33 patients who had had drooling attributable to various diseases, salivary fistulas, and sialadenitis and had been treated with injection of botulinum toxin type A (Botox). A controlled follow-up study documenting efficiency, possible side effects, and duration of the effect of treatment was also performed. Study Design: Retrospective clinical evaluation. Methods. Thirty-three patients with drooling attributable to head and neck carcinoma, neurodegenerative diseases, stroke, or idiopathic hypersalivation or with salivary fistula or chronic sialadenitis received injections of 20 to 65 U botulinum toxin type A into salivary glands under sonographic control. The entire salivary flow rate and the output per minute of the salivary analytes thiocyanate, total protein, alpha-amylase, acid phosphatase, kallikrein, and immunoglobulin A were measured at various times before and after injection. The patients were examined with regard to severity of their symptoms, including sonographic control investigation of their cephalic salivary glands. Results: Twenty-six patients (79% of all patients) reported a distinct improvement of their symptoms after toxin injection. Seven patients noted a return of high salivation rates and requested a second injection after 4 to 7 months. Duration of toxin effect varied widely among individuals. In general, salivary flow rates and thiocyanate output dropped sharply within 1 week after injection and had increased again after a period of 12 to 16 weeks. Conversely, amylase outputs increased during this period, whereas the outputs of the other analytes remained roughly constant. Sonography did not reveal any major changes in salivary gland parenchyma, and side effects were not noted. Conclusion: Reduction of salivary flow in patients with drooling, salivary fistulas, or chronic sialadenitis by local injection of botulinum toxin type A into the salivary glands proved to be a dependable therapy for these disorders, as shown in the present extended report on 33 patients. Side effects were not observed. The effect of toxin application lasted for approximately 3 months. Based on their results, the authors recommend botulinum toxin injection as the therapy of choice in patients with the problem of drooling
Occlusion of parotid salivary ducts with human fibrin glue: an experimental study with animals
No full textBotulinum toxin to reduce saliva flow: Selected indications for ultrasound-guided toxin application into salivary glands
No full textObjectives/Hypothesis: The study investigates the effect of local injections of botulinum. toxin type A (Botox) into the major salivary glands of the head in various states of hypersalivation. In particular, we studied pathological states with permanent as well as passing hypersalivation disorders and present new indications for local application of botulinum. toxin to the salivary glands. Study Design: Retrospective clinical investigation. Methods: A total of 55 to 65 units of Botox were injected under sonographic control into the left and right parotid and submandibular glands of four patients with hypersalivation resulting from head and neck carcinoma, tracheostomy, and "idiopathic" hypersalivation disorder. At defined time intervals following injection, flow rate, total protein and immunoglobulin A content, and the enzymatic activities of amylase, acid phosphatase, and kallikrein were determined in the saliva. The patients were clinically examined to assess the severity of their symptoms, including sonographic control of the major salivary glands. Results: All four patients reported distinct improvement of their symptoms within 1 week after injection. Salivary flow rate had considerably dropped, whereas the concentrations of the salivary components were much increased. Sonography did not reveal any changes of the salivary gland parenchyma. Therapeutic side effects were absent. Conclusions: Treatment of hypersalivation by local injections of Botox into the salivary glands of the head is a reliable and efficient therapy without side effects for certain otolaryngological diseases, especially if injections are performed under sonographic control. Extension of this therapeutic concept to other indications is suggested
Acetylcholine Receptor Concentration in the Mimic Musculature of the Rat Following Denervation and Reinnervation
No full textThe facial musculature of the rat was denervated by cutting the facial nerve. Over a period of 41 days no facial movements were observed. Acetylcholine receptor concentrations, determined by [125I]−agr−bungarotoxin binding, increased sharply in the early stage of denervation (at day 10) and were still significantly higher than in the controls after 41 days.
When cutting of the facial nerve was followed by immediate nerve repair (primary suture), facial movements returned on about day 16. The receptor concentrations reflected changes monitored by clinical observations. At day 10, when denervation of the facial muscles was still complete, receptor concentrations corresponded to those found in the permanently denervated muscles. At day 16 the reinnervated muscles of half the animals displayed muscle activity and had receptor concentrations identical to those found for normal (control) tissue. The other half of the animals, with no muscular activity detectable, had receptor concentrations as high as in permanently denervated tissue. After 23 days the receptor concentrations had essentially decreased to control levels and all rats had regained complete facial functio
