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Therapy of Sialorrhea with Botulinum Neurotoxin.
Neurol Ther. 2019 Dec; 8(2):273-288.NT

Abstract

Botulinum neurotoxin (BoNT) is considered the treatment of choice for various symptoms and diseases such as focal dystonia and focal spasticity. The effects of BoNT on the salivary glands have also been known for years, but their use was limited because of a lack of approval studies. Now the indication of sialorrhea is approved in some countries for incobotulinumtoxinA, such as the USA and Europe, and therapy could also become the treatment of choice. According to the pivotal study, a dose of 100 units of incobotulinumtoxinA, which is divided into the parotid and submandibular glands, is recommended. RimabotulinumtoxinB is approved in the USA only. To define the value of this therapy, we must consider anatomy, physiology, and available therapies. Therapy includes conservative measures such as functional dysphagia therapy, oral or transdermal application of anticholinergics, and, in selected cases, radiotherapy and surgical procedures. A combination of different approaches is optional. On the basis of the evidence and clinical experience, BoNT injections will be the first line of pharmacotherapy for chronic sialorrhea.

Authors+Show Affiliations

Parkinson-Klinik Ortenau, Wolfach, Germany. W.Jost@parkinson-klinik.de.Paediatric and Adult Movement Disorders and Neuropsychiatry, Institut of Neurogenetics, University of Lübeck, Lübeck, Germany.ENT Department, University Medical Center, Göttingen, Germany.Neurology Department, Medical University of Gdansk, Gdańsk, Poland.Center for Transdisciplinary Neurosciences Rostock (CTNR), University of Rostock, Rostock, Germany.Department for Otorhinolaryngology, University of Lübeck, UKSH, Lübeck, Germany.Krankenhaus Rummelsberg, Schwarzenbruck, Germany.Walton Centre NHS Foundation Trust, Liverpool, UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31542879

Citation

Jost, Wolfgang H., et al. "Therapy of Sialorrhea With Botulinum Neurotoxin." Neurology and Therapy, vol. 8, no. 2, 2019, pp. 273-288.
Jost WH, Bäumer T, Laskawi R, et al. Therapy of Sialorrhea with Botulinum Neurotoxin. Neurol Ther. 2019;8(2):273-288.
Jost, W. H., Bäumer, T., Laskawi, R., Slawek, J., Spittau, B., Steffen, A., Winterholler, M., & Bavikatte, G. (2019). Therapy of Sialorrhea with Botulinum Neurotoxin. Neurology and Therapy, 8(2), 273-288. https://doi.org/10.1007/s40120-019-00155-6
Jost WH, et al. Therapy of Sialorrhea With Botulinum Neurotoxin. Neurol Ther. 2019;8(2):273-288. PubMed PMID: 31542879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Therapy of Sialorrhea with Botulinum Neurotoxin. AU - Jost,Wolfgang H, AU - Bäumer,Tobias, AU - Laskawi,Rainer, AU - Slawek,Jaroslaw, AU - Spittau,Björn, AU - Steffen,Armin, AU - Winterholler,Martin, AU - Bavikatte,Ganesh, Y1 - 2019/09/21/ PY - 2019/08/09/received PY - 2019/9/23/pubmed PY - 2019/9/23/medline PY - 2019/9/23/entrez KW - Anticholinergics KW - Botulinum toxin KW - Drooling KW - Dysphagia KW - Sialorrhea SP - 273 EP - 288 JF - Neurology and therapy JO - Neurol Ther VL - 8 IS - 2 N2 - Botulinum neurotoxin (BoNT) is considered the treatment of choice for various symptoms and diseases such as focal dystonia and focal spasticity. The effects of BoNT on the salivary glands have also been known for years, but their use was limited because of a lack of approval studies. Now the indication of sialorrhea is approved in some countries for incobotulinumtoxinA, such as the USA and Europe, and therapy could also become the treatment of choice. According to the pivotal study, a dose of 100 units of incobotulinumtoxinA, which is divided into the parotid and submandibular glands, is recommended. RimabotulinumtoxinB is approved in the USA only. To define the value of this therapy, we must consider anatomy, physiology, and available therapies. Therapy includes conservative measures such as functional dysphagia therapy, oral or transdermal application of anticholinergics, and, in selected cases, radiotherapy and surgical procedures. A combination of different approaches is optional. On the basis of the evidence and clinical experience, BoNT injections will be the first line of pharmacotherapy for chronic sialorrhea. SN - 2193-8253 UR - https://www.unboundmedicine.com/medline/citation/31542879/Therapy_of_Sialorrhea_with_Botulinum_Neurotoxin L2 - https://dx.doi.org/10.1007/s40120-019-00155-6 DB - PRIME DP - Unbound Medicine ER -
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