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Safarpour D, Jabbari B. Botulinum Toxin Treatment for Cancer-Related Disorders: A Systematic Review. Toxins (Basel) 2023; 15:689. [PMID: 38133193 PMCID: PMC10748363 DOI: 10.3390/toxins15120689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
This systematic review investigates the effect of botulinum neurotoxin (BoNT) therapy on cancer-related disorders. A major bulk of the literature is focused on BoNT's effect on pain at the site of surgery or radiation. All 13 published studies on this issue indicated reduction or cessation of pain at these sites after local injection of BoNTs. Twelve studies addressed the effect of BoNT injection into the pylorus (sphincter between the stomach and the first part of the gut) for the prevention of gastroparesis after local resection of esophageal cancer. In eight studies, BoNT injection was superior to no intervention; three studies found no difference between the two approaches. One study compared the result of intra-pyloric BoNT injection with preventive pyloromyotomy (resection of pyloric muscle fibers). Both approaches reduced gastroparesis, but the surgical approach had more serious side effects. BoNT injection was superior to saline injection in the prevention of esophageal stricture after surgery (34% versus 6%, respectively, p = 0.02) and produced better results (30% versus 40% stricture) compared to steroid (triamcinolone) injection close to the surgical region. All 12 reported studies on the effect of BoNT injection into the parotid region for the reduction in facial sweating during eating (gustatory hyperhidrosis) found that BoNT injections stopped or significantly reduced facial sweating that developed after parotid gland surgery. Six studies showed that BoNT injection into the parotid region prevented the development of or healed the fistulas that developed after parotid gland resection-parotidectomy gustatory hyperhidrosis (Frey syndrome), post-surgical parotid fistula, and sialocele. Eight studies suggested that BoNT injection into masseter muscle reduced or stopped severe jaw pain after the first bite (first bite syndrome) that may develop as a complication of parotidectomy.
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Affiliation(s)
- Delaram Safarpour
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA;
| | - Bahman Jabbari
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06510, USA
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2
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Kim BS, Kim MR, Kim YW, Baek MJ, Suh TK, Kim SY. Risk factors for sialocele after parotidectomy: Does tumor size really matter? Auris Nasus Larynx 2023; 50:935-941. [PMID: 36922283 DOI: 10.1016/j.anl.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 02/06/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Sialocele that develops after parotid surgery often prolongs the treatment period and stresses both the surgeon and patient. The extent of surgery and tumor size are known to be associated with sialocele occurrence. We investigated the incidence of post-parotidectomy sialocele and the associated risk factors, with a focus on tumor size. METHODS We retrospectively reviewed the medical records of 172 patients who underwent parotidectomy between January 2013 and May 2020 at Haeundae Paik Hospital, Inje University of Korea. We stratified patients into those with and without sialocele (fluid collection in the operative bed). We compared clinical data, patient demographics, and surgical details; we identified risk factors for sialocele development after parotid surgery. RESULTS Seventeen patients were diagnosed with post-parotidectomy sialocele (9.88%; 17/172). Univariate logistic regression revealed that the male sex, deep lobe tumor location, and large tumor size were significantly associated with postoperative sialocele (p = 0.015, 0.009, and 0.016, respectively). We subjected these parameters to multivariate analyses; the odds ratios were 3.70, 3.58, and 2.34, respectively. Receiver operating characteristic curve analyses showed that a tumor size > 2.50 cm was the optimal cutoff in terms of predicting post-parotidectomy sialocele. CONCLUSION Male sex, a tumor in the deep lobe, and large tumor size were strongly associated with increased risk for sialocele after parotidectomy. Tumor size > 2.50 cm serves as the cutoff identifying patients likely to experience sialocele after parotid surgery.
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Affiliation(s)
- Bo-Soo Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Mi Ra Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Yong-Wan Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Moo Jin Baek
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Tae-Kyung Suh
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Republic of Korea
| | - Sang-Yeon Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Cochran J, Gottfried J, Chernichenko N, Walvekar RR, Butts SC. Traumatic Injuries of the Parotid Gland and Duct. Otolaryngol Clin North Am 2023; 56:1027-1038. [PMID: 37369609 DOI: 10.1016/j.otc.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
This review will focus on the key steps in the recognition of parotid gland and duct injuries focusing on the important steps needed at the initial assessment. Management planning is presented in the way that trauma surgeons interact with patients, highlighting the important parts of the informed consent conversation followed by the key information that must be communicated to the anesthesia and operating room teams, which ensures proper monitoring and equipment needs are in place. Short-term and long-term outcomes for patients with persistent sequelae of the trauma and their management are reviewed.
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Affiliation(s)
- James Cochran
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 126, Brooklyn, NY 11203, USA
| | - Jennifer Gottfried
- SUNY Downstate Health Sciences University-College of Medicine, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Natalya Chernichenko
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 126, Brooklyn, NY 11203, USA; Department of Otolaryngology-Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Rohan R Walvekar
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, 533 Bolivar Street, Suite 566, New Orleans, LA 70112, USA
| | - Sydney C Butts
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 126, Brooklyn, NY 11203, USA; Department of Otolaryngology-Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, NY 11203, USA.
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Ban MJ, Ryu CH, Woo JH, Lee YC, Lee DK, Kwon M, Hong YT, Lee GJ, Byeon HK, Choi SH, Lee SW. Guidelines for the Use of Botulinum Toxin in Otolaryngology From the Korean Society of Laryngology, Phoniatrics and Logopedics Guideline Task Force. Clin Exp Otorhinolaryngol 2023; 16:291-307. [PMID: 37905325 DOI: 10.21053/ceo.2023.00458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/25/2023] [Indexed: 11/02/2023] Open
Abstract
The Korean Society of Laryngology, Phoniatrics and Logopedics created a task force to establish clinical practice guidelines for the use of botulinum toxin (BT) in otolaryngology. We selected 10 disease categories: spasmodic dysphonia, essential vocal tremor, vocal fold granuloma, bilateral vocal fold paralysis, Frey's syndrome, sialocele, sialorrhea, cricopharyngeal dysfunction, chronic sialadenitis, and first bite syndrome. To retrieve all relevant papers, we searched the CORE databases with predefined search strategies, including Medline (PubMed), Embase, the Cochrane Library, and KoreaMed. The committee reported 13 final recommendations with detailed evidence profiles. The guidelines are primarily aimed at all clinicians applying BT to the head and neck area. In addition, the guidelines aim to promote an improved understanding of the safe and effective use of BT by policymakers and counselors, as well as in patients scheduled to receive BT injections.
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Affiliation(s)
- Myung Jin Ban
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Chang Hwan Ryu
- Department of Otorhinolaryngology-Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Joo Hyun Woo
- Department of Otorhinolaryngology-Head and Neck Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Young Chan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Dong Kun Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea
| | - Minsu Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong Tae Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
| | - Gil Joon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyung Kwon Byeon
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seung Ho Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung Won Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
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5
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Pereira IN, Hassan H. Botulinum toxin A in dentistry and orofacial surgery: an evidence-based review - part 1: therapeutic applications. Evid Based Dent 2022:10.1038/s41432-022-0256-9. [PMID: 35624296 DOI: 10.1038/s41432-022-0256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/31/2021] [Indexed: 11/08/2022]
Abstract
Objective An evidence-based review on the safety and efficacy of botulinum toxin type-A (BoNTA) in orofacial conditions, focusing on the therapeutic applications and role of BoNTA as an adjuvant treatment.Data source and selection Data was collected using PubMed (Medline), Cochrane Library of Systematic Reviews and Cochrane Central Register of Controlled Trials electronic databases. Having satisfied the search parameters, 32 studies for therapeutic applications and 26 for BoNTA as an adjunctive treatment were included. The quality of relevant studies was assessed using the Best Evidence Topics (BETs) Critical Appraisal Tool.Data extraction The highest level of evidence (LOE) behind BoNTA safety and efficacy was for wound healing and scar management in the orofacial surgery context, where BoNTA was presented as an adjunctive modality. Level-I evidence was controversial for temporomandibular disorders and bruxism. However, it showed promising results for painful temporomandibular disorders of myogenic origin refractory to conservative therapies, and to decrease muscle contraction intensity in sleeping bruxism. There was only one level-II study for persistent recurrent aphthous stomatitis. Data showed limited level-III evidence for orofacial pain conditions (temporomandibular joint recurrent dislocation and pain, burning mouth syndrome or atypical odontalgia), oral cancer complications, or as an adjuvant to maxillofacial and orthognathic surgeries. Benefits of BoNTA in prosthodontics had weak level-IV evidence. No evidence was found among the periodontology field.Conclusion There is growing evidence to support the safety and efficacy of BoNTA in the investigated orofacial pathological conditions, with high levels of satisfaction from the patient and clinician perspective. However, there are some inconsistencies and limited high-quality evidence available. Well-designed controlled clinical trials are necessary to evaluate long-term safety, efficacy and cost-effectiveness before BoNTA is widely adopted with irrefutable evidence-based clinical guidelines.
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Affiliation(s)
- Ines Novo Pereira
- Academic Plastic Surgery, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AT, UK
| | - Haidar Hassan
- Academic Plastic Surgery, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AT, UK.
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Weissler JM, Mohamed O, Gryskiewicz JM, Chopra K. An Algorithmic Approach to Managing Parotid Duct Injury Following Buccal Fat Pad Removal. Aesthet Surg J Open Forum 2022; 4:ojac032. [PMID: 35662908 PMCID: PMC9154315 DOI: 10.1093/asjof/ojac032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The principles of achieving an aesthetically pleasing and harmonious facial appearance are influenced by our evolving understanding of the three-dimensional topography of the face coupled with novel approaches to midface volumization and contouring. In parallel with the evolving landscape of facial aesthetic surgery, an increasing number of publications have emerged focusing on the role of intraoral buccal fat pad removal (BFPR) for the purposes of aesthetic midface contouring. The authors sought to emphasize an underreported and potentially preventable and untoward complication involving iatrogenic parotid duct injury following BFPR. The purpose of this publication is 3-fold: (1) to review the relevant anatomy and literature on intraoral BFPR, (2) to present a case example of this complication, and (3) to discuss treatment options as part of a proposed management algorithm. The authors detail the surgical indications for performing BFPR and review the relevant anatomic considerations. Complication prevention strategies are outlined, and details regarding avoidance of parotid duct injury are reviewed. The diagnostic criteria and clinical presentation of parotid duct injuries following BFPR are comprehensively outlined. The authors present a clinically actionable algorithm for managing a suspected or diagnosed parotid duct injury following BFPR. A clinical case example is discussed to highlight this complication, the diagnostic criteria, and the systematic and algorithmic approach to management. Intraoral BFPR is an incredibly valuable and powerful procedure that can improve facial contour in patients with buccal lipodystrophy or buccal fat pad pseudoherniation. The authors propose a proper diagnostic approach and treatment algorithm to manage this untoward complication. Level of Evidence 5
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Affiliation(s)
- Jason M Weissler
- Division of Plastic Surgery, Department of Surgery, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Omar Mohamed
- Division of Plastic Surgery, Department of Surgery, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | | | - Karan Chopra
- Corresponding Author:Dr Karan Chopra, Twin Cities Cosmetic Surgery, 303 E Nicollet Blvd #330, Burnsville, MN 55337, USA. E-mail: ; Instagram: @Karanchopramd
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Lee DJ, Lee YM, Park HJ, Lee JW, Cha W. Intraoperative botulinum toxin injection for superficial partial parotidectomy: A prospective pilot study. Clin Otolaryngol 2021; 46:998-1004. [PMID: 33754477 DOI: 10.1111/coa.13767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 12/04/2020] [Accepted: 03/14/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Sialocele and salivary fistula are not serious but troublesome complications after parotidectomy. Various modalities have been introduced to prevent postoperative saliva-related complications. However, clinical trials assessing the prophylactic use of botulinum toxin (BTX) for parotidectomy have not been conducted yet. Herein, we report a pilot study investigating the safety and efficacy of intraoperative BTX (iBTX) injection in partial superficial parotidectomy (PSP). PARTICIPANTS Patients with benign parotid tumour were prospectively recruited for this clinical trial from 2017 to 2019. The study participants underwent PSP with iBTX injection. We retrospectively reviewed the clinical information of all the consecutive patients who underwent PSP without iBTX from 2013 to 2019. These patients were divided into two groups: the iBTX group (n = 36) and the control group (n = 54). RESULTS Permanent facial palsy was not observed in either group. Two patients (3.7%) had transient marginal palsy in the control group but none had it in the iBTX group. The incidence of sialocele was significantly lower in the iBTX group than in the control group (2.8% vs. 20.4%, P < .05). Although the incidence of salivary fistula was lower in the iBTX group than in the control group (0% vs. 7.4%), no significant difference was determined between the two groups (P = .147). Total drainage volume was significantly lower in the iBTX group than in the control group (55.0 mL vs. 116.6 mL, P < .001). CONCLUSIONS iBTX injection may be safe and effective in reducing sialocele and postoperative drainage in PSP. It might be a useful option to prevent saliva-related complications after PSP.
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Affiliation(s)
- Dong-Joo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Yu-Mi Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Hye-Jin Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jung Woo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, South Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
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Management of Parotid Fistula After Mohs Micrographic Surgery. Dermatol Surg 2021; 47:538-539. [PMID: 32205744 DOI: 10.1097/dss.0000000000002367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Maharaj S, Mungul S, Laher A. Botulinum toxin A is an effective therapeutic tool for the management of parotid sialocele and fistula: A systematic review. Laryngoscope Investig Otolaryngol 2020; 5:37-45. [PMID: 32128429 PMCID: PMC7042652 DOI: 10.1002/lio2.350] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/26/2019] [Accepted: 01/02/2020] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES In the management of parotid sialocele and fistula, various conservative and surgical methods have been described. Some studies have described the use of Botulinum toxin A (Botox A) for the management of parotid sialocele and fistula. This is a less invasive and potentially equally effective option. We therefore conducted a systematic review on the current body of literature relating to this specific use of Botox A. METHODS A search strategy was conducted in July 2019 using the following electronic databases: Cochrane Database of Systematic Reviews, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science. A search of all articles from inception until 31 August 2019 was performed. RESULTS Literature searches of electronic databases identified 67 articles eligible for review, of which 15 fulfilled all criteria. These studies were small and in total only 47 patients were included. The majority of sialoceles and fistulas presented as a complication of surgery (77%) with the remaining cases occurring as a result of trauma. The typical age at presentation was between 32 and 88 years of age (mean age of 52 years). All patients were initially treated with and failed other conservative measures. Botox A injection was considered as a final conservative treatment option. The toxin was administered percutaneously in all cases of parotid sialocele and fistula. Dosage of Botox ranged from 10 to 200 units with majority of patients (58%) requiring only one injection. The overall success rate for patients treated with Botox A injections ranged between 70 and 100% for parotid sialoceles and fistulas. CONCLUSION Botox A injections are successful in the treatment of parotid sialoceles and fistulas and should be considered before the use of invasive conventional options. Further studies with larger numbers are needed to ratify this recommendation. Success rate for patients, treated with Botox A injection was between 70 and 100% for parotid sialocele and fistula. Patients who failed initial treatment with Botox A were re-administered with Botox A and eventually resolved.
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Affiliation(s)
- Shivesh Maharaj
- Charlotte Maxeke Johannesburg Academic Hospital, School of Neurosciences, Department of OtolaryngologyUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Sheetal Mungul
- Charlotte Maxeke Johannesburg Academic Hospital, School of Neurosciences, Department of OtolaryngologyUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Abdullah Laher
- Charlotte Maxeke Johannesburg Academic Hospital, School of Neurosciences, Department of OtolaryngologyUniversity of the WitwatersrandJohannesburgSouth Africa
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Botulinum Neurotoxins and Cancer-A Review of the Literature. Toxins (Basel) 2020; 12:toxins12010032. [PMID: 31948115 PMCID: PMC7020400 DOI: 10.3390/toxins12010032] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 12/31/2019] [Accepted: 01/01/2020] [Indexed: 01/20/2023] Open
Abstract
Botulinum neurotoxins (BoNT) possess an analgesic effect through several mechanisms including an inhibition of acetylcholine release from the neuromuscular junction as well as an inhibition of specific pain transmitters and mediators. Animal studies have shown that a peripheral injection of BoNTs impairs the release of major pain transmitters such as substance P, calcitonin gene related peptide (CGRP) and glutamate from peripheral nerve endings as well as peripheral and central neurons (dorsal root ganglia and spinal cord). These effects lead to pain relief via the reduction of peripheral and central sensitization both of which reflect important mechanisms of pain chronicity. This review provides updated information about the effect of botulinum toxin injection on local pain caused by cancer, painful muscle spasms from a remote cancer, and pain at the site of cancer surgery and radiation. The data from the literature suggests that the local injection of BoNTs improves muscle spasms caused by cancerous mass lesions and alleviates the post-operative neuropathic pain at the site of surgery and radiation. It also helps repair the parotid damage (fistula, sialocele) caused by facial surgery and radiation and improves post-parotidectomy gustatory hyperhidrosis. The limited literature that suggests adding botulinum toxins to cell culture slows/halts the growth of certain cancer cells is also reviewed and discussed.
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Bancalari B, Llombart B, Requena C, Vendrell J. Parotid Fistula After Skin Biopsy: Treatment With Botulinum Toxin. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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12
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A Functional Approach to Posttraumatic Salivary Fistula Treatment: The Use of Botulinum Toxin. J Craniofac Surg 2019; 30:871-875. [PMID: 30807467 DOI: 10.1097/scs.0000000000005293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This manuscript highlights key aspects regarding the practical use of botulinum toxin for the conservative nonsurgical treatment of a rarely encountered, but significant posttraumatic complication-the parotid salivary fistula. It adds information to the scarce existing literature on the subject. The authors outline the main differences between postoperative and trauma-related parotid injury regarding salivary fistula treatment. A total of 6 patients with trauma-related salivary fistulas have been treated by Abobotulinum toxin A injections over the course of 5 years. The technique is detailed, describing the doses used in the presence of parenchyma and duct injuries, the location and number of injection points in relation to the wound pattern. The results were favorable, leading to the healing of the salivary fistulas in all patients, with 1 injection session, without additional conservative treatment. In our experience, the use of botulinum toxin is of great benefit for treating salivary fistulas in a traumatic context.
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Bancalari B, Llombart B, Requena C, Vendrell JB. Parotid Fistula After Skin Biopsy: Treatment With Botulinum Toxin. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:693-695. [PMID: 31151670 DOI: 10.1016/j.ad.2018.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/13/2018] [Accepted: 02/19/2018] [Indexed: 10/26/2022] Open
Affiliation(s)
- B Bancalari
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
| | - B Llombart
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - C Requena
- Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España
| | - J B Vendrell
- Servicio de Otorrinolaringología, Instituto Valenciano de Oncología, Valencia, España
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Kang YJ, Cha BK, Choi DS, Jang IS, Kim SG. Botulinum toxin-A injection into the anterior belly of the digastric muscle for the prevention of post-operative open bite in class II malocclusions: a case report and literature review. Maxillofac Plast Reconstr Surg 2019; 41:17. [PMID: 31093487 PMCID: PMC6484054 DOI: 10.1186/s40902-019-0201-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 03/21/2019] [Indexed: 11/23/2022] Open
Abstract
Background Class II malocclusion patients with hyperdivergent facial types are characterized by short mandibular body lengths and anterior open bite. Accordingly, the treatment for hyperdivergent skeletal class II malocclusion is a lengthening of the mandibular body length and a counterclockwise rotation of the mandible. To prevent post-operative relapse, botulinum toxin-A (BTX-A) injection can be a retention modality. Case presentation A class II open-bite patient received BTX-A injection to the anterior belly of her digastric muscle for the prevention of post-operative relapse. The relapse was evaluated via a clinical examination and a lateral cephalometric radiograph after the completion of post-surgical orthodontic treatment. The patient showed stable occlusion without any signs of relapse at 15 months post-operatively. Conclusion In this case presentation, a single injection into the anterior belly of the digastric muscle was sufficient for the prevention of post-operative open bite.
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Affiliation(s)
- Yei-Jin Kang
- 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
| | - Bong Kuen Cha
- 2Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
| | - Dong Soon Choi
- 2Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
| | - In San Jang
- 2Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
| | - Seong-Gon Kim
- 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644 Republic of Korea
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Gallo A, Manciocco V, Pagliuca G, Martellucci S, de Vincentiis M. Transdermal Scopolamine in the Management of Postparotidectomy Salivary Fistula. EAR, NOSE & THROAT JOURNAL 2019. [DOI: 10.1177/0145561313092010-1113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Andrea Gallo
- Department of Otorhinolaryngology, “Sapienza” University of Rome, Italy
| | - Valentina Manciocco
- Department of Otolaryngology/Head and Neck Surgery, National Cancer Institute Regina Elena, Rome
| | - Giulio Pagliuca
- Department of Otorhinolaryngology, “Sapienza” University of Rome, Italy
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Pendolino AL, Zanoletti E, Guarda-Nardini L, Marchese-Ragona R. In reference to management and follow-up results of salivary fistulas treated with botulinum toxin. Laryngoscope 2019; 129:E166-E167. [PMID: 30768686 DOI: 10.1002/lary.27682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 09/21/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Alfonso Luca Pendolino
- Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy
| | - Elisabetta Zanoletti
- Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy
| | - Luca Guarda-Nardini
- Department of Dentistry and Maxillofacial Surgery, Treviso Hospital, Treviso, Italy
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17
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Hu CY, Shang ZJ, Qin X, Shao LN. Application of Delayed Surgical Managements in Patients with Stensen's Duct Injury. Curr Med Sci 2018; 38:519-523. [PMID: 30074221 DOI: 10.1007/s11596-018-1909-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 04/20/2018] [Indexed: 10/28/2022]
Abstract
The study aimed to retrospectively evaluate surgical treatment outcomes after delayed parotid gland and duct injuries. Nine patients subjected to parotid gland and duct injuries with 1- to 3-month treatment delay were retrospectively evaluated with special reference of etiology, past medical history, and injury location. Conservative treatment, microsurgical anastomosis, and diversion of salivary flow or ligation were chosen for delayed parotid gland and duct injuries concerning to their site of injury, time of repair and procedures. Assistant treatment as pressure dressing was adopted thereafter. All patients experienced an uneventful recovery at the time of finalizing the study. Two patients received Stensen's duct ligation, 5 received microsurgical anastomosis and 2 accepted salivary flow diversion for 5 patients with sialoceles and 4 patients with fistulas, and no re-occurrence was found. Facial paralysis occurred after surgery in 4 patients, and 3 of them recovered after the nerve nutrition treatment. Our study suggested that appropriate surgical treatment is efficient for the re-establishment of the tissue function and facial aesthetic for delayed injury of the parotid and its duct.
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Affiliation(s)
- Chuan-Yu Hu
- Department of Oral and Maxillofacial-Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, 430060, China.,Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zheng-Jun Shang
- Department of Oral and Maxillofacial-Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, 430060, China.
| | - Xu Qin
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Le-Nan Shao
- Center of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Lovato A, Restivo DA, Ottaviano G, Marioni G, Marchese-Ragona R. Botulinum toxin therapy: functional silencing of salivary disorders. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:168-171. [PMID: 28516981 PMCID: PMC5463526 DOI: 10.14639/0392-100x-1608] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 01/21/2023]
Abstract
Botulinum toxin (BTX) is a neurotoxic protein produced by Clostridium botulinum, an anaerobic bacterium. BTX therapy is a safe and effective treatment when used for functional silencing of the salivary glands in disorders such as sialoceles and salivary fistulae that may have a post-traumatic or post-operative origin. BTX injections can be considered in sialoceles and salivary fistulae after the failure of or together with conservative treatments (e.g. antibiotics, pressure dressings, or serial aspirations). BTX treatment has a promising role in chronic sialadenitis. BTX therapy is highly successful in the treatment of gustatory sweating (Frey's syndrome), and could be considered the gold standard treatment for this neurological disorder.
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Affiliation(s)
- A Lovato
- Department of Neuroscience DNS, University of Padova, Audiology Unit at Treviso Hospital, Treviso, Italy
| | - D A Restivo
- Department of Internal Medicine, Neurologic Unit, Nuovo "Garibaldi" Hospital, Catania, Italy
| | - G Ottaviano
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Italy
| | - G Marioni
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Italy
| | - R Marchese-Ragona
- Otolaryngology Section, Department of Neuroscience DNS, University of Padova, Italy
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Bayet K, Chikhani L, Ejeil AL. Therapeutic uses and efficacy of botulinum toxin in orofacial medicine. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2018. [DOI: 10.1051/mbcb/2017030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Botulinum toxin, primarily known for its use in cosmetic surgery, is also used for therapeutic purposes in many medical fields. It works as a muscle relaxant and inhibits glandular secretions. In the orofacial sphere, the use of this toxin is proposed in particular for disabling myofascial pain and aberrant salivary disorders. Methodology: A critical analysis of the literature, based on PUBMED data, concerning the orofacial indications of botulinum toxin was carried out. Results: The literature is abundant regarding the therapeutic interest of this toxin for several oral pathologies, but scientific merits vary markedly from one indication to another. Discussion: The musculorelaxant and antisecretory action of this toxin appears to be demonstrated in the case of bruxism, limitation of the mouth opening and in hypersialorrhea. On the other hand, its medical benefit is still not supported by scientific evidence for masseter hypertrophy, tonicity of the levator labii superioris muscles, sialocele fistulae and Frey's syndrome. Conclusion: Additional high-level studies, unbiased, randomized controlled trials, are required to eliminate the uncertainties that persist about the clinical impact of botulinum toxin and to justify the development of recommendations for good practice valid and credible.
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Nath T, Imran M, Megu K, Shafath A, Thongdok KW. Management of Maxillofacial Injuries Sustained after a Bear Attack. Ann Maxillofac Surg 2018; 8:369-372. [PMID: 30693268 PMCID: PMC6327797 DOI: 10.4103/ams.ams_169_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
There is a little available literature on injuries sustained due to bear attacks and their management. Bears are agile wild animals and injuries sustained after a bear attack have varying patterns. In general, such cases present to the emergency department with severe maxillofacial injuries with varying patterns, thereby limiting the use of common protocol for the management of such injuries. The aim of this article is to add to the current available literature on bear attacks, a present case of management of maxillofacial injury involving the orbit sustained after a bear attack.
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Affiliation(s)
- Tanmoy Nath
- Department of Oral and Maxillofacial Surgery, Regional Dental College, Guwahati, Assam, India
| | - Mohammed Imran
- Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India
| | - Kaling Megu
- Department of General Surgery, Heema Hospital, Itanagar, Arunachal Pradesh, India
| | - Adil Shafath
- Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India
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21
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Botulinumtoxin in der HNO‑Heilkunde – ein Update. HNO 2017; 65:859-870. [DOI: 10.1007/s00106-017-0409-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hong SE, Kwon JW, Kang SR, Park BY. The Effect of Botulinum Toxin on an Iatrogenic Sialo-Cutaneous Fistula. Arch Craniofac Surg 2017; 17:237-239. [PMID: 28913292 PMCID: PMC5556845 DOI: 10.7181/acfs.2016.17.4.237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 12/13/2016] [Accepted: 12/13/2016] [Indexed: 11/22/2022] Open
Abstract
A sialo-cutaneous fistula is a communication between the skin and a salivary gland or duct discharging saliva. Trauma and iatrogenic complications are the most common causes of this condition. Treatments include aspiration, compression, and the administration of systemic anticholinergics; however, their effects are transient and unsatisfactory in most cases. We had a case of a patient who developed an iatrogenic sialo-cutaneous fistula after wide excision of squamous cell carcinoma in the parotid region that was not treated with conventional management, but instead completely resolved with the injection of botulinum toxin. Based on our experience, we recommend the injection of botulinum toxin into the salivary glands, especially the parotid gland, as a conservative treatment option for sialo-cutaneous fistula.
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Affiliation(s)
- Seung Eun Hong
- Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jung Woo Kwon
- Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - So Ra Kang
- Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Bo Young Park
- Department of Plastic and Reconstructive Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
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23
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Zeng L, Jiang C, Li N, Liu W, Wang F, Guo F. Vascularized Fascia Lata for Prevention of Postoperative Parotid Fistula Arising From Partial Parotidectomy During Neck Dissection. J Oral Maxillofac Surg 2017; 75:1071-1080. [DOI: 10.1016/j.joms.2016.10.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 10/17/2016] [Accepted: 10/17/2016] [Indexed: 11/26/2022]
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24
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Melville JC, Stackowicz DJ, Jundt JS, Shum JW. Use of Botox (OnabotulinumtoxinA) for the Treatment of Parotid Sialocele and Fistula After Extirpation of Buccal Squamous Cell Carcinoma With Immediate Reconstruction Using Microvascular Free Flap: A Report of 3 Cases. J Oral Maxillofac Surg 2016; 74:1678-86. [DOI: 10.1016/j.joms.2016.01.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/22/2016] [Accepted: 01/22/2016] [Indexed: 10/22/2022]
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25
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Novel approach in the treatment of a persistent iatrogenic parotid fistula using AlloDerm® – an allogenic acellular dermal matrix. Br J Oral Maxillofac Surg 2016; 54:109-10. [DOI: 10.1016/j.bjoms.2015.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 09/14/2015] [Indexed: 11/22/2022]
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26
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Jeffe JS, Sulman CG. The use of botulinum toxin B in the treatment of a post-traumatic sialocele in a 4-year-old child: A case report. Int J Pediatr Otorhinolaryngol 2015; 79:2446-9. [PMID: 26471923 DOI: 10.1016/j.ijporl.2015.09.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 12/26/2022]
Abstract
Parotid sialoceles are bothersome complications of parotidectomy and penetrating injury to the parotid gland. Though typically self-limited and responsive to conservative management, they can be particularly difficult to manage in the pediatric population where even conservative interventions are less well tolerated. We present the case of a 4-year-old child with a post-traumatic parotid sialocele that was successfully managed with a single injection of botulinum toxin B. To our knowledge, this is the first reported case of the use of botulinum toxin for this purpose in the pediatric population.
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Affiliation(s)
- Jill S Jeffe
- Deparment of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL, United States.
| | - Cecille G Sulman
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, United States
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27
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Lee YC, Park GC, Lee JW, Eun YG, Kim SW. Prevalence and risk factors of sialocele formation after partial superficial parotidectomy: A multi-institutional analysis of 357 consecutive patients. Head Neck 2015; 38 Suppl 1:E941-4. [DOI: 10.1002/hed.24130] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 04/13/2015] [Accepted: 05/14/2015] [Indexed: 11/07/2022] Open
Affiliation(s)
- Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery; School of Medicine, Kyung Hee University; Seoul Korea
| | - Gi Cheol Park
- Department of Otolaryngology; Samsung Changwon Hospital, Sungkyunkwan University School of Medicine; Changwon Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery; School of Dentistry, Kyung Hee University; Seoul Korea
| | - Young Gyu Eun
- Department of Otolaryngology-Head and Neck Surgery; School of Medicine, Kyung Hee University; Seoul Korea
| | - Seung Woo Kim
- Department of Otolaryngology-Head and Neck Surgery; Veterans Health Service Medical Center; Seoul Korea
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28
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Ibrahim FF, Cardona I, Smith MM, Daniel SJ. Onabotulinum toxin injection for parotid fistula treatment in a case of recurrent parotitis complicated with abscess formation. Int J Pediatr Otorhinolaryngol 2015; 79:766-8. [PMID: 25819498 DOI: 10.1016/j.ijporl.2015.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 02/28/2015] [Accepted: 03/02/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Farid F Ibrahim
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Isabel Cardona
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Mariana M Smith
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Sam J Daniel
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada.
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29
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Alshadwi A, Nadershah M, Osborn T. Therapeutic applications of botulinum neurotoxins in head and neck disorders. Saudi Dent J 2014; 27:3-11. [PMID: 25544809 PMCID: PMC4273262 DOI: 10.1016/j.sdentj.2014.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 08/18/2014] [Accepted: 10/20/2014] [Indexed: 11/06/2022] Open
Abstract
Objective The aim of this article is to review the mechanism of action, physiological effects, and therapeutic applications of botulinum neurotoxins in the head and neck area. Study design An extensive literature search was performed using keywords. The resulting articles were analyzed for relevance in four areas: overview on botulinum neurotoxins, the role of botulinum neurotoxins in the management of salivary secretory disorders, the role of botulinum neurotoxins in the management of facial pain, and the role of botulinum neurotoxins in head and neck movement disorders. Institutional review board approval was not needed due the nature of the study. Results Botulinum neurotoxin therapy was demonstrated to be a valuable alternative to conventional medical therapy for many conditions affecting the head and neck area in terms of morbidly, mortality, and patient satisfaction with treatment outcomes. Conclusion Botulinum neurotoxin therapy provides viable alternatives to traditional treatment modalities for some conditions affecting the head and neck region that have neurological components. This therapy can overcome some of the morbidities associated with conventional therapy. More research is needed to determine the ideal doses of botulinum neurotoxin to treat different diseases affecting the head and neck regions.
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Affiliation(s)
- Ahmad Alshadwi
- Department of Oral and Maxillofacial Surgery, Boston University-Henry M. Goldman School of Dental Medicine, 100 East Newton Street, Suite G-407, Boston, MA 02118, United States ; King Feisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammed Nadershah
- Academic Faculty King Abdulaziz University-Dental School, Jeddah, Saudi Arabia
| | - Timothy Osborn
- Department of Oral and Maxillofacial Surgery, Boston University-Henry M. Goldman School of Dental Medicine, 100 East Newton Street, Suite G-407, Boston, MA 02118, United States
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Stensen's duct injuries: the role of sialendoscopy and adjuvant botulinum toxin injection. Wideochir Inne Tech Maloinwazyjne 2013; 8:112-6. [PMID: 23837095 PMCID: PMC3699770 DOI: 10.5114/wiitm.2011.32851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 12/17/2012] [Accepted: 12/27/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Stensen's duct injuries are uncommon but troublesome sequelae of facial surgery or other external traumas. AIM To investigate the feasibility of sialendoscopic control of Stensen's duct in iatrogenic injuries and the efficiency of botulinum toxin adjuvant therapy. MATERIAL AND METHODS In 2008 and 2010, 5 patients with parotid sialoceles or fistulas, infrequent complications after plastic surgery or trauma, were treated in a single institution, Poznan University of Medical Sciences ENT Department. The group consisted of 5 patients with diagnosed Stensen's duct injuries, which were post-surgery and post-traumatic sequelae. All were treated by means of open surgery. Botulinum toxin injection was administered during the procedure to decrease the saliva secretion and to improve the healing process. A sialendoscopy was performed to control the lumen of the junction after the duct injury was repaired. RESULTS Complete healing of the fistulas and sialoceles after the reparative surgery followed by a single botulinum toxin application was observed in all patients within 10-14 days. No side effects were noticed. CONCLUSIONS Our findings suggest that sialendoscopy is a valuable tool and an important step of control in the surgery of parotid duct injuries and the injection of botulinum toxin is an effective and safe second-line treatment.
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Laskawi R, Winterhoff J, Köhler S, Kottwitz L, Matthias C. Botulinum toxin treatment of salivary fistulas following parotidectomy: follow-up results. Oral Maxillofac Surg 2012. [PMID: 23179957 PMCID: PMC3832751 DOI: 10.1007/s10006-012-0375-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Salivary fistulas are a well-known sequel of parotidectomy, and successful treatment with botulinum toxin has been demonstrated in individual cases. Here, we report on 12 patients with fistulas treated following parotidectomy for various indications. METHODS AND RESULTS Injection of botulinum toxin type A into the residual gland tissue was the initial treatment. After early intervention (within 6 weeks after development of the fistula), only one fistula remained (9 of 10 fistulas treated early only with botulinum toxin). One patient with early intervention did not want to wait for the botulinum toxin treatment to take effect and demanded early surgical revision, which was successful. In one patient with a permanent fistula, botulinum toxin treatment began 420 days after the operation and was unsuccessful. No side effects were evident after the treatment. CONCLUSION In summary, botulinum toxin injections into the parotid tissue remaining after surgery appear to be an effective treatment for salivary fistulas following parotidectomy.
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Affiliation(s)
- Rainer Laskawi
- Department of Otorhinolaryngology, University of Göttingen Medical Center, Robert-Koch-Str. 40, 37075, Göttingen, Lower Saxony, Germany,
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Lawson GA, Kreymerman P, Nahai F. An unusual complication following rhytidectomy: iatrogenic parotid injury resulting in parotid fistula/sialocele. Aesthet Surg J 2012; 32:814-21. [PMID: 22942108 DOI: 10.1177/1090820x12455798] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Rhytidectomy is a common surgical procedure performed by today's aesthetic surgeons. Newer trends and techniques leading to deeper and more aggressive dissection have placed the parotid gland at increased risk for injury during this procedure. Despite there being a relative abundance of literature on traumatic parotid injury, there is a relative paucity of information on iatrogenic parotid injury after rhytidectomy. In addition, there is no consensus on management of these complications. In this article, the authors discuss 3 case reports, review the relevant literature, and propose a treatment algorithm. Early diagnosis and appropriate treatment are essential to properly manage this complication.
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Affiliation(s)
- George A Lawson
- Forsyth Plastic Surgery, Winston-Salem, North Carolina 27103, USA.
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33
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Posttraumatic parotid fistula treated with transdermal scopolamine: a case report. Case Rep Surg 2012; 2012:713148. [PMID: 22919533 PMCID: PMC3420077 DOI: 10.1155/2012/713148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 07/04/2012] [Indexed: 11/18/2022] Open
Abstract
A parotid fistula is a rare and extremely unpleasant condition. In this paper, we present the case of a 53-year-old woman with a diagnosis of posttraumatic fistula of the parotid gland. After exclusion of other therapeutic alternatives, it was decided to use transdermal scopolamine patches at sustained release (Scopoderm TTS). This technique consists in the application every three days of a patch with 1.5 mg of scopolamine in the area of the mastoid apophysis; the patch releases a dose of 0.5 mg of the active substance over each 24-hour period. The patient underwent periodic clinical followup over a period of three years, achieving satisfactory results with no significant adverse effects.
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Majid O. Clinical use of botulinum toxins in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 2010; 39:197-207. [DOI: 10.1016/j.ijom.2009.10.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Revised: 06/15/2009] [Accepted: 10/30/2009] [Indexed: 12/12/2022]
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35
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Technical notes published in BJOMS over a 2-year period—Should we be doing it differently? Br J Oral Maxillofac Surg 2009; 47:306-9. [DOI: 10.1016/j.bjoms.2009.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2009] [Indexed: 11/18/2022]
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36
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37
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Iatrogenic Parotid Sialocele After Excision of Malignant Melanoma of the Cheek. Dermatol Surg 2008. [DOI: 10.1097/00042728-200811000-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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38
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Bomeli SR, Desai SC, Johnson JT, Walvekar RR. Management of salivary flow in head and neck cancer patients – A systematic review. Oral Oncol 2008; 44:1000-8. [DOI: 10.1016/j.oraloncology.2008.02.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Revised: 02/14/2008] [Accepted: 02/15/2008] [Indexed: 11/29/2022]
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39
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Abramova L, Mann M, Hessler J, Sengelmann RD. Iatrogenic parotid sialocele after excision of malignant melanoma of the cheek. Dermatol Surg 2008; 34:1584-8. [PMID: 18798743 DOI: 10.1111/j.1524-4725.2008.34329.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Liana Abramova
- Department of Internal Medicine, Division of Dermatology, Washington University School of Medicine, St Louis, MO 63110, USA.
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40
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Botulinum toxin therapy: a tempting tool in the management of salivary secretory disorders. Am J Otolaryngol 2008; 29:333-8. [PMID: 18722890 DOI: 10.1016/j.amjoto.2007.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 09/18/2007] [Accepted: 10/09/2007] [Indexed: 11/20/2022]
Abstract
PURPOSE The aim of the study was to investigate the feasibility and effectiveness of botulinum toxin therapy in salivary secretory disorders. MATERIALS AND METHODS We treated 24 patients with botulinum neurotoxin type A for drooling, salivary fistulas, sialoceles, recurrent parotitis, and Frey's syndrome; each parotid gland and submandibular gland received 25 to 60 and 10 to 40 mouse units, respectively, per session. All the patients other than those with Frey's syndrome underwent, for diagnostic purpose, color Doppler ultrasonography (Hitachi H 21; frequency, 7.5 MHz, Scanner, Kashiwa, Japan), and Minor's test was carried out for gustatory sweating; pretreatment magnetic resonance sialography (Philips Gyroscan Intera, Eindhoven, The Netherlands) and sialoendoscopy were also performed in selected cases. The follow-up included clinical and ultrasonographic examinations and Minor's test. RESULTS A clinical improvement was observed in all patients: complete clinical recovery in 12, subtotal in 6, and partial in 6. A self-assessment test suggested the cessation of sweating by the 10th day in most patients with Frey's syndrome. Botulinum toxin lost its effectiveness approximately after 4 months, requiring further administrations especially for drooling. No major side effects were observed with the exception of transitory paresis of the lower branch of the facial nerve in a patient with concomitant autonomic diabetic neuropathy. CONCLUSIONS Our findings suggest that botulinum toxin therapy is valid for the nonsurgical management of patients with salivary secretory disorders; the use of color Doppler ultrasonographic monitoring warrants the safety of the procedure.
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Lim YC, Choi EC. Treatment of an acute salivary fistula after parotid surgery: botulinum toxin type A injection as primary treatment. Eur Arch Otorhinolaryngol 2007; 265:243-5. [PMID: 17704932 DOI: 10.1007/s00405-007-0418-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Accepted: 07/25/2007] [Indexed: 10/22/2022]
Abstract
A salivary fistula is a relatively uncommon but troublesome complication after parotid surgery. Most cases are self-limiting and respond well to conservative therapy (compression dressings). However, this treatment may require weeks before its effect becomes evident. We present the first report of direct administration of botulinum toxin type A as an effective primary treatment for an acute salivary fistula after parotid surgery, in the absence of other, more conservative treatment. A 47-year-old man with a 7-day history of sore throat was found to have a parapharyngeal tumor originating from the deep lobe of the parotid gland. He underwent tumor removal via a trans-paroticocervical approach. However, on postoperative day 7, the patient was noted to have massive salivary discharge from the surgical incision during a meal. We administered a transcutaneous botulinum toxin type A injection without a pressure dressing. One day after the injection, the salivary discharge from the incision line disappeared completely and there was no evidence of recurrent sialorrhea in the 6 months following the procedure. This report suggests that the injection of botulinum toxin type A is a highly effective and relatively safe primary method of treatment for an acute postparotidectomy salivary fistula, and not merely an alternative to more conservative therapy.
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Affiliation(s)
- Young Chang Lim
- Department of Otorhinolaryngology, Head and Neck Surgery, Konkuk University School of Medicine, Hwayang-dong, Gwangin-gu, Seoul, South Korea.
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