Accuracy of Ultrasound-Guided and Non-ultrasound-Guided Botulinum Toxin Injection Into Cadaver Salivary Glands
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Objective To compare the accuracy of ultrasound (US)-guided and non-US-guided botulinum toxin (BTX) injection into the salivary glands (parotid and submandibular glands) of cadavers.Methods Two rehabilitation physician injected dye into three sites in the salivary glands (two sites in the parotid gland and one site in the submandibular gland) on one side of each cadaver (one was injected on the right side, while the other was injected on the left side), using either a non-US-guided injection procedure based on superficial landmarks or a US-guided procedure. Orange dye was used for the US-guided procedure, and green dye was used for the blind procedure. Two physicians uninvolved with the injection procedures and who were blinded to the method of injection dissected the cadavers to identify whether the dye was accurately injected into each target site.Results The accuracies of the blind and US-guided injections into the parotid gland were 79.17% and 95.83%, respectively. In the submandibular gland, the accuracies of the blind and US-guided injections were 50.00% and 91.67%, respectively. The difference in accuracy between the two procedures was statistically significant only in the submandibular gland (p=0.025). There were no significant differences in the accuracy of US-guided and non-US-guided injections between the two physicians for the two sites in the parotid gland (p=0.278 and p=0.146, respectively).Conclusion US-guided BTX injection into the submandibular gland offers significantly greater accuracy over blind injection. For the treatment of drooling by injecting BTX into the submandibular gland, clinicians should consider using US guidance for improved accuracy.
Abstract
Objective To compare the accuracy of ultrasound (US)-guided and non-US-guided botulinum toxin (BTX) injection into the salivary glands (parotid and submandibular glands) of cadavers.Methods Two rehabilitation physician injected dye into three sites in the salivary glands (two sites in the parotid gland and one site in the submandibular gland) on one side of each cadaver (one was injected on the right side, while the other was injected on the left side), using either a non-US-guided injection procedure based on superficial landmarks or a US-guided procedure. Orange dye was used for the US-guided procedure, and green dye was used for the blind procedure. Two physicians uninvolved with the injection procedures and who were blinded to the method of injection dissected the cadavers to identify whether the dye was accurately injected into each target site.Results The accuracies of the blind and US-guided injections into the parotid gland were 79.17% and 95.83%, respectively. In the submandibular gland, the accuracies of the blind and US-guided injections were 50.00% and 91.67%, respectively. The difference in accuracy between the two procedures was statistically significant only in the submandibular gland (p=0.025). There were no significant differences in the accuracy of US-guided and non-US-guided injections between the two physicians for the two sites in the parotid gland (p=0.278 and p=0.146, respectively).Conclusion US-guided BTX injection into the submandibular gland offers significantly greater accuracy over blind injection. For the treatment of drooling by injecting BTX into the submandibular gland, clinicians should consider using US guidance for improved accuracy.
참고문헌 (13)
- Garnock-Jones KP, "Glycopyrrolate oral solution: for chronic, severe drooling in pediatric patients with neurologic conditions", Paediatr Drugs, 14, pp.263~269 (2012)
- Jongerius PH, "The treatment of posterior drooling by botulinum toxin in a child with cerebral palsy", J Pediatr Gastroenterol Nutr, 41, pp.351~353 (2005)
- Lakraj AA, "Sialorrhea: anatomy, pathophysiology and treatment with emphasis on the role of botulinum toxins", Toxins (Basel), 5, pp.1010~1031 (2013)
- Meningaud JP, "Drooling of saliva: a review of the etiology and management options", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 101, pp.48~57 (2006)
- Bushara KO, "Sialorrhea in amyotrophic lateral sclerosis:a hypothesis of a new treatment: botulinum toxin A injections of the parotid glands", Med Hypotheses, 48, pp.337~339 (1997)
- Sriskandan N, "Ultrasound-guided submandibular gland injection of botulinum toxin for hypersalivation in cerebral palsy", Br J Oral Maxillofac Surg, 48, pp.58~60 (2010)
- Dogu O, "Ultrasound-guided versus ‘blind’ intraparotid injections of botulinum toxin-A for the treatment of sialorrhoea in patients with Parkinson’s disease", Clin Neurol Neurosurg, 106, pp.93~96 (2004)
- Lagalla G, "Long-lasting benefits of botulinum toxin type B in Parkinson’s disease-related drooling", J Neurol, 256, pp.563~567 (2009)
- Lee JH, "Anatomical localization of submandibular gland for botulinum toxin injection", Surg Radiol Anat, 32, pp.945~949 (2010)
- Scully C, "Drooling", J Oral Pathol Med, 38, pp.321~327 (2009)
- Jongerius PH, "The treatment of drooling by ultrasound-guided intraglandular injections of botulinum toxin type A into the salivary glands", Laryngoscope, 113, pp.107~111 (2003)
- Svetel M, "Botulinum toxin in the treatment of sialorrhea", Vojnosanit Pregl, 66, pp.9~12 (2009)
- Lim M, "Botulinum toxin in the management of sialorrhoea: a systematic review", Clin Otolaryngol, 31, pp.267~272 (2006)