Affiliation:
1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
Abstract
Objectives Botulinum toxin has emerged as an effective approach for the management of sialorrhea. This study presents a critical literature review and meta-analysis to determine the impact of botulinum toxin on drooling severity in patients with sialorrhea. Data Sources Ovid MEDLINE and the Cochrane databases. Review Methods The above sources were searched to identify studies examining botulinum toxin for the treatment of sialorrhea. Included studies were randomized, placebo-controlled trials. Excluded studies failed to report quantifiable outcome measures of drooling severity at 4 weeks postintervention. Results Eight studies involving 181 patients (83 placebo; 98 active) were included in the analysis. Botulinum toxin was found to significantly decrease the severity of drooling in patients with sialorrhea (standardized mean difference [SMD], −1.54; 95% confidence interval [CI], −2.05 to −1.04; P = .06; I2 = 48%) when compared with placebo control using random effects models. The effect was significant in both adult (SMD, −1.29; 95% CI, −1.88 to −0.71) and pediatric (SMD, −1.84; 95% CI, −2.67 to −1.00) populations. Both botulinum toxin A (SMD, −1.53; 95% CI, −2.27 to −0.79) and B (SMD, −1.56; 95% CI, −2.32 to −0.79) produced similar effects. Botulinum toxin doses greater than 50 U (SMD, −3.81; 95% CI, –6.19 to −1.43) produced much stronger effects compared with doses less than or equal to 50 U (SMD, −1.32; 95% CI, −2.28 to −0.36). Conclusion Botulinum toxin is a clinically effective therapy that improves drooling severity in patients with sialorrhea. Future studies will need to further evaluate the technique and examine dosages required to achieve optimal outcomes.
Subject
Otorhinolaryngology,Surgery
Cited by
64 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献