Sialorrhea or excessive
salivation, and
drooling, are common and disabling manifestations in different
neurological disorders. A
review is made of the
literature, based on a
PubMed search, selecting those articles describing clinical trialsinvolving the
injection of
botulinum toxin A in the
salivary glands of
patients with different
diseases characterized by
sialorrhea.The most frequently treated
diseases were
infant cerebral palsy (30%), Parkinsons
disease (20%) and
amyotrophic lateral sclerosis (15%). Over half of the authors injected the product into the
parotid glands, 9.5% into the
submaxillary glands, and 38% into both. The total doses of toxin injected varied from 10-100 units of
Botox® or 30-450 units of Dysport®according to the different authors. A reduction was observed in the
production of
saliva following these
injections, and the duration of the
therapeutic effect was 1.5-6 months. Six articles (30%) described the presence of
adverse effects such as
dysphagia,
xerostomia and
chewing difficulties.Most of the clinical studies involved small
patient samples, with no blinding or
randomization, and no
control group.Moreover, no data are available on the
efficacy and
adverse effects of
treatment in the context of long-term
prospective studies. The effective
therapeutic dose and ideal form of application remain to be established, and require the conduction of further controlled clinical trials involving large
sample sizes (AU)