Marina M B, Sani A, Hamzaini A H, Hamidon B B
Department of Otorhinolaryngology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.
J Laryngol Otol. 2008 Jun;122(6):609-14. doi: 10.1017/S0022215107008730. Epub 2007 Jul 19.
Dribbling (sialorrhoea) affects about 10 per cent of patients with chronic neurological disease. The variety of treatments currently available is unsatisfactory. This study was a clinical trial of the efficacy of ultrasound-guided, intraglandular injection of botulinum toxin A for dribbling, performed within the otorhinolaryngology department of the National University of Malaysia. Both pairs of parotid and submandibular glands received 25 U each of botulinum toxin A. Twenty patients were enrolled in the study. The median age was 15 years. All 20 patients (or their carers) reported a distinct improvement in symptoms after injection. Using the Wilcoxon signed rank test, there were significant reductions in dribbling rating score, dribbling frequency score, dribbling severity score, dribbling visual analogue score and towel changes score, comparing pre- and post-injection states (p<0.001). There were no complications or adverse effects during or after the injection procedure. Intraglandular, major salivary gland injection of botulinum toxin A is an effective treatment to reduce dribbling. Ultrasound guidance enhances the accuracy of this procedure and minimises the risk of complication.
流涎（唾液分泌过多）影响约10%的慢性神经疾病患者。目前可用的各种治疗方法都不尽人意。本研究是在马来西亚国立大学耳鼻喉科进行的一项关于超声引导下腺体内注射A型肉毒杆菌毒素治疗流涎疗效的临床试验。双侧腮腺和下颌下腺各注射25单位A型肉毒杆菌毒素。20名患者参与了该研究。中位年龄为15岁。所有20名患者（或其护理人员）均报告注射后症状有明显改善。使用Wilcoxon符号秩检验，比较注射前后状态，流涎评分、流涎频率评分、流涎严重程度评分、流涎视觉模拟评分和毛巾更换评分均有显著降低（p<0.001）。注射过程中及注射后均无并发症或不良反应。腺体内注射A型肉毒杆菌毒素是减少流涎的有效治疗方法。超声引导提高了该操作的准确性，并将并发症风险降至最低。
