Journal of Neurology

, Volume 262, Issue 12, pp 2662–2667 | Cite as

Long-term follow-up of ultrasound-guided botulinum toxin-A injections for sialorrhea in neurological dysphagia

  • Pierangelo Barbero
  • Marco Busso
  • Marco Tinivella
  • Carlo Alberto Artusi
  • Stefania De Mercanti
  • Angele Cucci
  • Andrea Veltri
  • Paolo Avagnina
  • Andrea Calvo
  • Adriano Chio’
  • Luca Durelli
  • Marinella Clerico
Original Communication

Abstract

Literature provides reports only of a limited follow-up single injection of botulinum toxin-A (BoNT-A) in patients with sialorrhea. The aim of our study is to evaluate the long-lasting efficacy and safety of ultrasound-guided BoNT-A injections for severe sialorrhea secondary to neurological dysphagia. We enrolled 38 severe adult sialorrhea patients referred consecutively to the neurology unit and performed bilateral parotid and submandibular gland BoNT-A injections under ultrasound guidance. The outcomes of the study were reduction of sialorrhea, duration of therapeutic effect, and subjective patient- and caregiver-reported satisfaction. A total of 113 BoNT-A administrations were given during the study period with a mean duration of follow-up of 20.2 ± 4.4 months. We observed a significant decrease from baseline in mean number of daily aspirations and a significant improvement in patient- and caregiver-reported outcomes following ultrasound-guided BoNT-A injections (p < 0.001 vs baseline for all comparisons) and the mean duration of the efficacy was 5.6 ± 1 months. No major treatment-related adverse events occurred and a low incidence of minor adverse events was reported. This study confirms the long-lasting efficacy and safety of ultrasound-guided BoNT-A injections for sialorrhea, regardless of the causative neurological disorder. These results should encourage the use of BoNT-A in the treatment of severe sialorrhea and highlight the role of ultrasound guidance to obtain optimal results in terms of safety and reproducible outcomes.

Keywords

Dysphagia Sialorrhea Botulinum toxin Ultrasound-guided botulinum toxin-A injections Drooling Neurological diseases 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Pierangelo Barbero
    • 1
  • Marco Busso
    • 2
  • Marco Tinivella
    • 3
  • Carlo Alberto Artusi
    • 1
  • Stefania De Mercanti
    • 1
  • Angele Cucci
    • 1
  • Andrea Veltri
    • 2
  • Paolo Avagnina
    • 3
  • Andrea Calvo
    • 4
  • Adriano Chio’
    • 4
  • Luca Durelli
    • 1
  • Marinella Clerico
    • 1
  1. 1.Clinical and Biological Sciences Department, Neurology UnitUniversity of Torino, San Luigi Gonzaga HospitalOrbassanoItaly
  2. 2.Oncology Department, Radiology UnitUniversity of Torino, San Luigi Gonzaga HospitalOrbassanoItaly
  3. 3.Clinical and Biological Sciences Department, Dietologic And Nutrition DepartmentUniversity of Torino, San Luigi Gonzaga HospitalOrbassanoItaly
  4. 4.ALS Center, “Rita Levi Montalcini” Department of Neuroscience, Neurology IIUniversity of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della ScienzaTorinoItaly

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