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Botulinum Toxin A for Oral Cavity Cancer Patients: In Microsurgical Patients BTX Injections in Major Salivary Glands Temporarily Reduce Salivary Production and the Risk of Local Complications Related to Saliva Stagnation

Department of Surgical Oncology, Plastic Surgery Unit, University of Palermo, Italy
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Received: 31 August 2012 / Revised: 25 September 2012 / Accepted: 18 October 2012 / Published: 24 October 2012
(This article belongs to the Special Issue Clinical Use of Botulinum Toxins)
In patients suffering from oral cavity cancer surgical treatment is complex because it is necessary to remove carcinoma and lymph node metastasis (through a radical unilateral or bilateral neck dissection) and to reconstruct the affected area by means of free flaps. The saliva stagnation in the post-operative period is a risk factor with regard to local complications. Minor complications related to saliva stagnation (such as tissue maceration and wound dehiscence) could become major complications compromising the surgery or the reconstructive outcome. In fact the formation of oro-cutaneous fistula may cause infection, failure of the free flap, or the patient’s death with carotid blow-out syndrome. Botulinum injections in the major salivary glands, four days before surgery, temporarily reduces salivation during the healing stage and thus could reduce the incidence of saliva-related complications. Forty three patients with oral cancer were treated with botulinum toxin A. The saliva quantitative measurement and the sialoscintigraphy were performed before and after infiltrations of botulinum toxin in the major salivary glands. In all cases there was a considerable, but temporary, reduction of salivary secretion. A lower rate of local complications was observed in the post-operative period. The salivary production returned to normal within two months, with minimal side effects and discomfort for the patients. The temporary inhibition of salivary secretion in the post-operative period could enable a reduction in saliva-related local complications, in the incidence of oro-cutaneous fistulas, and improve the outcome of the surgery as well as the quality of residual life in these patients. View Full-Text
Keywords: Botulinum toxin; salivary production; oral cancer; free flap complications; saliva-related complications; forearm free flap; oro-cutaneous fistula; salivary major glands Botulinum toxin; salivary production; oral cancer; free flap complications; saliva-related complications; forearm free flap; oro-cutaneous fistula; salivary major glands
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MDPI and ACS Style

Corradino, B.; Di Lorenzo, S.; Moschella, F. Botulinum Toxin A for Oral Cavity Cancer Patients: In Microsurgical Patients BTX Injections in Major Salivary Glands Temporarily Reduce Salivary Production and the Risk of Local Complications Related to Saliva Stagnation. Toxins 2012, 4, 956-961. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins4110956

AMA Style

Corradino B, Di Lorenzo S, Moschella F. Botulinum Toxin A for Oral Cavity Cancer Patients: In Microsurgical Patients BTX Injections in Major Salivary Glands Temporarily Reduce Salivary Production and the Risk of Local Complications Related to Saliva Stagnation. Toxins. 2012; 4(11):956-961. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins4110956

Chicago/Turabian Style

Corradino, Bartolo, Sara Di Lorenzo, and Francesco Moschella. 2012. "Botulinum Toxin A for Oral Cavity Cancer Patients: In Microsurgical Patients BTX Injections in Major Salivary Glands Temporarily Reduce Salivary Production and the Risk of Local Complications Related to Saliva Stagnation" Toxins 4, no. 11: 956-961. https://0-doi-org.brum.beds.ac.uk/10.3390/toxins4110956

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