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Lee, Park, Jo, Choi, and Byun: Effects of Botulinum Toxin A Injection into Salivary Glands of Patients with Brain Lesion Suffering from Posterior Drooling
Original Article
Brain & Neurorehabilitation

Brain & Neurorehabilitation 2011; 4(2): 121-125.

Published online: 30 September 2011

DOI: https://doi.org/10.12786/bn.2011.4.2.121

Effects of Botulinum Toxin A Injection into Salivary Glands of Patients with Brain Lesion Suffering from Posterior Drooling

Zee Ihn Lee, M.D., Dong Hwi Park, M.D., Dong Hyun Jo, M.D., Won-Duck Choi, M.D., Seung Deuk Byun, M.D.

Department of Rehabilitation Medicine, Daegu Fatima Hospital, Korea.

Corresponding author (bdome@hanmail.net)

Received 28 February 2011       Accepted 15 July 2011

Copyright © 2011 Korean Society for Neurorehabilitation

Abstract

Objective

The aim of the study was to evaluate the effectiveness of ultrasouond-guided salivary gland injection of botulinum toxin A (BTX-A) for posterior drooling.

Method

11 patients with brain lesion (9 cerebral palsy, 1 hypoxic ischemic encephalopathy and 1 mental retardation) with posterior drooling (an initial PDAS score greater than 2) and related pulmonary problems were recruited. Drooling severity was measured at baseline, 4 weeks, 3 months and 6 months after botulinum toxin A injection, by using Teacher Drooling Scale (TDS), Visual Analogue Scales (VAS), Drooling Score System (DSS)-severity, frequency and Posterior Drooling/Aspiration System (PDAS).

Results

The TDS, DSS-severity, DSS-frequency, VAS, PDAS were significantly reduced at 4 weeks and 3 months after BTX-A injection into salivary glands compared to pre-injection (p<0.05). However, there were no significant changes at 6 months compared to pre-injection level.

Conclusion

BTX-A injection into salivary glands may improve anterior drooling in patients with brain lesions. Furthermore BTX-A injection into salivary glands may also decrease the posterior drooling which might related to respiratory symptoms in aspiration pneumonia.

Keywords: botulinum toxin type A, drooling, salivary glands

Figures and Tables

Fig. 1
These figure shows the ultrasound guided botulinum toxin injection into salivary gland. Submandibular gland before botulinum toxin injection (A) after botulinum toxin injection (B).
bn-4-121-g001
Table 1
Characteristics of Patients
bn-4-121-i001

CP: Cerebral palsy, HIE: Hypoxic ischemic encephalopathy, PEG: Percutaneous endoscopic gastrostomy, L-tube: Levin tube, Bwt: Body Weight, GMFCS: Gross motor function classification system.

Table 2
Posterior Drooling/Aspiration Scale
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Table 3
Mean TDS, DSS-Severity, Frequency, VAS, PDAS Score Changes after Botulinum Toxin Injection
bn-4-121-i003

TDS: teacher drooling scale, DSS: drooling score system, VAS: visual analogue scale, PDAS: posterior drooling/aspiration scale. *p<0.05.

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