Winterholler M
Neurologische Klinik, Krankenhaus Rummelsberg, Schwarzenbruck bei Nürnberg. winterholler. rummelsberger.net
Pneumologie. 2008 Mar;62 Suppl 1:S39-42. doi: 10.1055/s-2007-1016440.
Sialorrhea (drooling or excessive salivation) is a common problem in patients with progressive neurolomuscular diseases and bulbar palsy. Contributing factors are hypersecretion of saliva induced by cholinergic drugs and poor dental status. Non-invasive ventilation is often severely impaired in these patients. Treatment should be initiated with a thorough evaluation of the medication and of the oral status by an otorhinolaryngologist. As drooling is commonly caused by poor oral or pharyngeal neuromuscular control, swallowing therapy should be initiated by a speech therapist. Further treatment options are anticholinergic medications, botulinum toxin injections into the salivary gland, radiation and and surgical procedures. Whereas systemic anticholinergic medications lead often to side effects, the (ultrasound-guided) injection of botulinum toxin into the parotid and submandibular gland is a safe and effective method for controlling drooling for at least 2 months.
流涎（流口水或唾液分泌过多）是进行性神经肌肉疾病和延髓麻痹患者的常见问题。促成因素包括胆碱能药物引起的唾液分泌过多以及口腔状况不佳。这些患者的无创通气功能往往严重受损。应由耳鼻喉科医生对药物和口腔状况进行全面评估后开始治疗。由于流涎通常是由口腔或咽部神经肌肉控制不良引起的，因此应由言语治疗师开始吞咽治疗。进一步的治疗选择包括抗胆碱能药物、向唾液腺注射肉毒杆菌毒素、放射治疗和外科手术。虽然全身性抗胆碱能药物常常会导致副作用，但（超声引导下）向腮腺和下颌下腺注射肉毒杆菌毒素是一种安全有效的控制流涎至少2个月的方法。
