Shariat-Madar Bahbak, Chun Robert H, Sulman Cecille G, Conley Stephen F
Children's Hospital of Wisconsin, Department of Otolaryngology/Medical College of Wisconsin, Children's Hospital Clinics Building, Milwaukee, Wisconsin, USA.
Children's Hospital of Wisconsin, Department of Otolaryngology/Medical College of Wisconsin, Children's Hospital Clinics Building, Milwaukee, Wisconsin, USA
Otolaryngol Head Neck Surg. 2016 May;154(5):924-7. doi: 10.1177/0194599816629612. Epub 2016 Feb 23.
To evaluate incidence of complications and hospital readmission as a result of ultrasound-guided botulinum toxin injections to manage sialorrhea.
Case series with chart review.
Children's Hospital of Wisconsin.
A case series with chart review was performed of all cases of ultrasound-guided injection of botulinum toxin by pediatric otolaryngologists from March 5, 2010, to September 26, 2014,. Primary outcomes included complications such as dysphagia, aspiration pneumonia, and motor paralysis. Secondary outcomes included hospitalization, intubation, and nasogastric tube placement.
There were 48 patients, 111 interventions, and 306 intraglandular injections identified. Botulinum toxin type A and type B were utilized in 4 and 107 operative interventions, respectively. Type A was injected into 4 parotid and 4 submandibular glands, utilizing doses of 20 U per parotid and 30 U per submandibular gland. Type B was injected into 98 parotid and 200 submandibular glands, with average dosing of 923 U per parotid and 1170 U per submandibular gland, respectively. There were 2 instances of subjectively worsening of baseline dysphagia that self-resolved. No cases were complicated by aspiration pneumonia or motor paralysis. No patients required hospital readmission, intubation, or nasogastric tube placement.
Prior published data indicated 16% complication incidence with ultrasound-guided injection of botulinum toxin. Our study found a low complication rate (0.6%) with ultrasound-guided injections of botulinum toxin to manage sialorrhea, without cases of aspiration pneumonia or motor paralysis. Of 306 intraglandular injections, there were 2 cases of worsening baseline subjective dysphagia that self-resolved.
评估超声引导下注射肉毒杆菌毒素治疗流涎症的并发症发生率及再入院情况。
病例系列研究并进行病历回顾。
威斯康星儿童医院。
对2010年3月5日至2014年9月26日期间儿科耳鼻喉科医生进行的所有超声引导下注射肉毒杆菌毒素的病例进行病例系列研究并进行病历回顾。主要结局包括吞咽困难、吸入性肺炎和运动麻痹等并发症。次要结局包括住院、插管和鼻胃管置入。
共识别出48例患者、111次干预和306次腺体内注射。分别有4次和107次手术干预使用了A型和B型肉毒杆菌毒素。A型毒素注射到4个腮腺和4个下颌下腺，每个腮腺剂量为20 U，每个下颌下腺剂量为3 U。B型毒素注射到98个腮腺和200个下颌下腺，每个腮腺平均剂量为923 U，每个下颌下腺平均剂量为1170 U。有2例基线吞咽困难主观上加重但自行缓解。无吸入性肺炎或运动麻痹并发症病例。无患者需要再次入院、插管或放置鼻胃管。
先前发表的数据表明超声引导下注射肉毒杆菌毒素的并发症发生率为16%。我们的研究发现，超声引导下注射肉毒杆菌毒素治疗流涎症的并发症发生率较低（0.6%），无吸入性肺炎或运动麻痹病例。在306次腺体内注射中，有2例基线主观吞咽困难加重但自行缓解。
