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[Hypersalivation - Update of the S2k guideline (AWMF) in short form].

Abstract

Hypersalivation describes a relatively excessive salivary flow, which wets the patient himself and his surroundings. It may result because of insufficient oro-motor function, dysphagia, decreased central control and coordination. This update presents recent changes and innovation in the treatment of hypersalivation.Multidisciplinary diagnostic and treatment evaluation is recommended already at early stage and focus on dysphagia, saliva aspiration, and oro-motor deficiencies. Clinical screening tools and diagnostics such as fiberoptic endoscopic evaluation of swallowing generate important data on therapy selection and control. Many cases profit from swallowing therapy programmes in order to activate compensation mechanisms as long compliances is given. In children with hypotonic oral muscles, oral stimulation plates can induce a relevant symptom release because of the improved lip closure. The pharmacologic treatment improved for pediatric cases as glycopyrrolate fluid solution (Sialanar®) is now indicated for hypersalivation within the E. U. The injection of botulinum toxin into the salivary glands has shown safe and effective results with long lasting saliva reduction. Here, a phase III trial is completed for Incobotulinum toxin A and, in the U. S., is indicated for the treatment of adult patients with chronic hypersalivation. Surgical treatment should be reserved for isolated cases. External radiation is judged as a safe and effective therapy when using modern 3 D techniques to minimize tissue damage. Therapy effects and symptom severity has to be followed, especially in cases with underlying neurodegenerative disease.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Universität zu Lübeck HNO-Klinik.

    ,

    Universitätsmedizin Göttingen, HNO-Klinik.

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    Universitätsklinikum Münster Klinik für Psychiatrie und Psychotherapie.

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    Wissenschaftliches Institut für angewandte HNO-Heilkunde HNO-Praxis Bad Bramstedt.

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    Curavid Praxis für Strahlentherapie Radiologie.

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    Evangelische Hochschule Berlin Pflege- und Gesundheitswissenschaften.

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    Phoniatrie Universitätsklinikum Schleswig-Holstein.

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    Gemeinschaftspraxis Am Rosenplatz.

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    Dr. von Haunersches Kinderspital Ludwig-Maximilians-Universität München Pädiatrische Neurologie und Entwicklungsneurologie.

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    Ludwig-Maximilians-Universität München, Medizinische Fakultät, Institut für Phonetik und Sprachverarbeitung.

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    Klinikum der Universität München, Klinik für Hals-, Nasen- und Ohrenheilkunde.

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    Parkinson-Klinik Ortenau GmbH & Co. KG.

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    HELIOS Fachklinik Schleswig, Psychiatry and Psychosomatik Medicine.

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    Praxis für Neurologie, Psychiatrie, Psychotherapie und Nervenheilkunde.

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    Universitätsklinikum der FSU Jena HNO.

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    Universität zu Lübeck, Institut für Neurogenetik.

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    Georg-August-Universität Göttingen, Universitätsmedizin Klinik für Hals-Nasen-Ohrenheilkunde.

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    Friedrich-Alexander-Universität Erlangen-Nürnberg, Medizinische Fakultät, Studiengang B. Sc. Logopädie.

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    Evangelisches Krankenhaus Oldenburg Klinik für Neurologische Intensivmedizin und Frührehabilitation.

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    Uniklinik Köln Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie Köln.

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    Universität zu Lübeck, Klinik für Kiefer- und Gesichtschirurgie.

    Medizinische Hochschule Hannover, Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie.

    Source

    Laryngo- rhino- otologie 98:6 2019 Jun pg 388-397

    Pub Type(s)

    English Abstract
    Journal Article

    Language

    ger

    PubMed ID

    31167292

    Citation

    Steffen, Armin, et al. "[Hypersalivation - Update of the S2k Guideline (AWMF) in Short Form]." Laryngo- Rhino- Otologie, vol. 98, no. 6, 2019, pp. 388-397.
    Steffen A, Jost W, Bäumer T, et al. [Hypersalivation - Update of the S2k guideline (AWMF) in short form]. Laryngorhinootologie. 2019;98(6):388-397.
    Steffen, A., Jost, W., Bäumer, T., Beutner, D., Degenkolb-Weyers, S., Groβ, M., ... Guntinas-Lichius, O. (2019). [Hypersalivation - Update of the S2k guideline (AWMF) in short form]. Laryngo- Rhino- Otologie, 98(6), pp. 388-397. doi:10.1055/a-0874-2406.
    Steffen A, et al. [Hypersalivation - Update of the S2k Guideline (AWMF) in Short Form]. Laryngorhinootologie. 2019;98(6):388-397. PubMed PMID: 31167292.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - [Hypersalivation - Update of the S2k guideline (AWMF) in short form]. AU - Steffen,Armin, AU - Jost,Wolfgang, AU - Bäumer,Tobias, AU - Beutner,Dirk, AU - Degenkolb-Weyers,Sabine, AU - Groβ,Martin, AU - Grosheva,Maria, AU - Hakim,Samer, AU - Kahl,Kai G, AU - Laskawi,Rainer, AU - Lencer,Rebekka, AU - Löhler,Jan, AU - Meyners,Thekla, AU - Rohrbach-Volland,Saskia, AU - Schönweiler,Rainer, AU - Schröder,Sara-Christina, AU - Schröder,Sebastian, AU - Schröter-Morasch,Heidrun, AU - Schuster,Maria, AU - Steinlechner,Susanne, AU - Urban,Roland, AU - Guntinas-Lichius,Orlando, Y1 - 2019/06/05/ PY - 2019/6/6/entrez PY - 2019/6/6/pubmed PY - 2019/6/6/medline SP - 388 EP - 397 JF - Laryngo- rhino- otologie JO - Laryngorhinootologie VL - 98 IS - 6 N2 - Hypersalivation describes a relatively excessive salivary flow, which wets the patient himself and his surroundings. It may result because of insufficient oro-motor function, dysphagia, decreased central control and coordination. This update presents recent changes and innovation in the treatment of hypersalivation.Multidisciplinary diagnostic and treatment evaluation is recommended already at early stage and focus on dysphagia, saliva aspiration, and oro-motor deficiencies. Clinical screening tools and diagnostics such as fiberoptic endoscopic evaluation of swallowing generate important data on therapy selection and control. Many cases profit from swallowing therapy programmes in order to activate compensation mechanisms as long compliances is given. In children with hypotonic oral muscles, oral stimulation plates can induce a relevant symptom release because of the improved lip closure. The pharmacologic treatment improved for pediatric cases as glycopyrrolate fluid solution (Sialanar®) is now indicated for hypersalivation within the E. U. The injection of botulinum toxin into the salivary glands has shown safe and effective results with long lasting saliva reduction. Here, a phase III trial is completed for Incobotulinum toxin A and, in the U. S., is indicated for the treatment of adult patients with chronic hypersalivation. Surgical treatment should be reserved for isolated cases. External radiation is judged as a safe and effective therapy when using modern 3 D techniques to minimize tissue damage. Therapy effects and symptom severity has to be followed, especially in cases with underlying neurodegenerative disease. SN - 1438-8685 UR - https://www.unboundmedicine.com/medline/citation/31167292/[Hypersalivation_-_Update_of_the_S2k_guideline_(AWMF)_in_short_form] L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/a-0874-2406 DB - PRIME DP - Unbound Medicine ER -