Lim M, Mace A, Nouraei S A Reza, Sandhu G
Department of Otolaryngology and Head and Neck Surgery, Royal Free Hospital, London, UK.
Clin Otolaryngol. 2006 Aug;31(4):267-72. doi: 10.1111/j.1749-4486.2006.01263.x.
Sialorrhoea can be a significant problem in both adults and children and can cause both physical and psychosocial problems. Botulinum toxin has enjoyed an emergence in the treatment of sialorrhoea, a systematic review of the evidence for botulinum toxin reveals two randomised controlled trials (RCTs) and four other trials that fulfilled our inclusion criteria. Both RCTs demonstrate the effectiveness of botulinum toxin in the management of sialorrhoea. There was no clear evidence for one antigenic type of botulinum toxin over another and minimal evidence for the optimal dose of botulinum toxin for each antigenic type. No advantage is conferred in using ultrasound guidance in injecting the glands. None of the RCTs or other studies directly compared submandibular versus parotid injection or directly compared botulinum toxin against surgery. Minor side effects were reported in one of the RCTs but overall botulinum toxin is a safe, minimally invasive and effective means in the treatment of sialorrhoea with the potential to become the treatment of choice. Our review demonstrates that further randomised controlled trials are required to more fully evaluate this new modality of treatment.
流涎在成人和儿童中都可能是一个严重的问题，并且会导致身体和心理社会问题。肉毒杆菌毒素在流涎治疗中已逐渐兴起，一项关于肉毒杆菌毒素证据的系统评价显示有两项随机对照试验（RCT）以及其他四项符合我们纳入标准的试验。两项RCT均证明肉毒杆菌毒素在治疗流涎方面的有效性。没有明确证据表明一种抗原型肉毒杆菌毒素优于另一种，且关于每种抗原型肉毒杆菌毒素的最佳剂量的证据极少。在注射腺体时使用超声引导并无优势。没有一项RCT或其他研究直接比较下颌下注射与腮腺注射，或直接比较肉毒杆菌毒素与手术。其中一项RCT报告了轻微的副作用，但总体而言，肉毒杆菌毒素是一种安全、微创且有效的治疗流涎的方法，有可能成为首选治疗方法。我们的综述表明，需要进一步的随机对照试验来更全面地评估这种新的治疗方式。
