Does botulinum toxin injection in parotid glands interfere with the swallowing dynamics of Parkinson's disease patients?

• Published in: Clinical neurology and neurosurgery Vol. 111; no. 5; pp. 430 - 432
• Main Authors: Nóbrega, Ana Caline, Rodrigues, Bernardo, Melo, Ailton
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01-06-2009; Elsevier; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Barium; Biological and medical sciences; Botulinum toxin; Botulinum Toxins, Type A - administration & dosage; Botulinum Toxins, Type A - adverse effects; Botulinum Toxins, Type A - therapeutic use; Confidence intervals; Deglutition - drug effects; Deglutition - physiology; Deglutition Disorders - chemically induced; Deglutition Disorders - diagnostic imaging; Deglutition Disorders - physiopathology; Dysphagia; Female; Food; Humans; Injections; Male; Meals; Medical sciences; Middle Aged; Neurology; Neuromuscular Agents - administration & dosage; Neuromuscular Agents - adverse effects; Neuromuscular Agents - therapeutic use; Neurosurgery; Oropharynx - diagnostic imaging; Oropharynx - physiopathology; Parkinson Disease - complications; Parkinson Disease - drug therapy; Parkinson Disease - physiopathology; Parkinson's disease; Parotid Gland; Sialorrhea; Sialorrhea - drug therapy; Sialorrhea - physiopathology; Silent aspiration; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Swallowing disorders; Ultrasonography; Swallowing disorders; Dysphagia; Silent aspiration; Parkinson's disease; Botulinum toxin; Sialorrhea; Parotid gland; Esophageal disease; Parkinson disease; Metalloendopeptidases; Swallowing; Bontoxilysin; Surgery; Degenerative disease; Human; Nervous system diseases; Enzyme; Stomatology; Aspiration; Cerebral disorder; Peptidases; Central nervous system disease; Hydrolases; Digestive diseases; Extrapyramidal syndrome
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2008.12.007

Abstract Background During recent years, sialorrhea in Parkinson's disease (PD) has been treated with botulinum toxin type A (BT-A); however, there are no data describing its effects on swallowing dynamics in this group of patients. Objective To investigate whether injection of BT-A into the parotid glands interferes with the oropharyngeal swallowing dynamics of patients with Parkinson's disease. Methods Sixteen patients with diurnal sialorrhea were selected and evaluated during the “on” period by a standardized questionnaire and swallowing videofluoroscopy before and 30 days after ultrasound-guided BT-A injection into the parotid glands. Results A decrease in sialorrhea was observed in all studied patients. Silent laryngeal penetration was observed in three patients, and silent aspiration was observed in two of them. There were no changes in swallowing dynamics when comparing patients before and after BT-A parotid injection ( p = 1), suggesting similar levels of dysphagia in the two measurements. Conclusion BT-A injection into parotid glands does not interfere with the oropharyngeal swallowing dynamics of PD patients.