J Korean Dysphagia Soc.  2015 Jan;5(1):1-6.

Botulinum Toxin Treatment for Sialorrhea

  • 1Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Korea


Sialorrhea is a distressing symptom for the patients with neurological conditions including cerebral palsy, parkinson's disease, amyotrophic lateral sclerosis and stroke, and it is mainly related to the disturbance in oral motor control rather than the excessive production of saliva in that patients. It can lead to some medical issues like oral hygiene, dentition and perioral dermatitis, and have a negative impact on social interaction. Also, the posterior drooling can cause coughing, choking and even serious respiratory complications such as aspiration pneumonia. A range of interventions, which are behavioral approach, pharmacologic approach, botulinum toxin (BoTN) injection, radiotherapy or surgery, exist that aim to reduce sialorrhea but there is a lack of consensus on management approach. Over the last decade, the injection of BoTN to salivary glands has emerged as a promising method to reduce sialorrhea and has been accepted as an effective and safe treatment in patients with neurological condition. Recently, several researchers tried to develop an international consensus statement, providing expert recommendations on assessment, intervention with BoTN, and aftercare for both pediatric and adult drooling. Sialorrea will be best managed by a multidisciplinary team, starting with a conservative approach and then leading to more invasive procedures as appropriate.


Sialorrhea; Salivary gland; Botulinum toxin injection
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