Manrique Dayse
Department of Otorhinolaryngology, UNIFESP.
Braz J Otorhinolaryngol. 2005 Sep-Oct;71(5):566-9. doi: 10.1016/s1808-8694(15)31258-1. Epub 2006 Mar 31.
To demonstrate the effect of local application of Botox(R) in patients with amyotrophic lateral sclerosis (ALS), following our 2002 institutional protocol of sialorrhea treatment.
Clinical prospective.
Five patients with ALS assisted at Clinic of Otolaryngology of AACD (Associação de Assistência à Criança Deficiente). They were all submitted to local application of Botox in salivary glands and followed up for a year. The protocol consisted of clinical questionnaire about the inability of swallowing saliva and its repercussions in quality of life. Patients were submitted to previous odontological treatment, had intolerance to the adverse effects of anti-cholinergic agents and had not used Botox for at least six months. The application was guided by ultrasound and the doses were 30U in one point for submandibular gland, and 20U in two points for each parotid gland, after topic anesthetic with prilocaine.
Five patients with ALS with sialorrhea, aged 45 to 59 years, were submitted to Botox salivary glands application. We observed that the symptoms of sialorrhea changed dramatically in four patients. Three patients stayed almost four months without complaints with repercussion in quality of life. No patient presented local or systemic effects with local injection of Botox.
按照我们2002年制定的治疗流涎症的机构方案，证明局部应用保妥适（Botox®）对肌萎缩侧索硬化症（ALS）患者的疗效。
临床前瞻性研究。
五名ALS患者在AACD（儿童援助协会）耳鼻喉科诊所接受治疗。他们均接受了保妥适在唾液腺的局部应用，并随访一年。方案包括关于吞咽唾液困难及其对生活质量影响的临床问卷调查。患者之前接受过牙科治疗，对抗胆碱能药物的不良反应不耐受，且至少六个月未使用过保妥适。应用过程由超声引导，在下颌下腺一点注射剂量为30U，在每个腮腺两点注射剂量为20U，注射前用丙胺卡因进行局部麻醉。
五名患有流涎症的ALS患者，年龄在45至59岁之间，接受了保妥适唾液腺注射。我们观察到，四名患者的流涎症状有显著改善。三名患者几乎四个月没有出现相关症状，生活质量得到改善。局部注射保妥适后，没有患者出现局部或全身不良反应。
