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[Sialorrhea, hyperhidrosis and botulinum toxin]
G Monnier1, L Tatu, B Parratte
1Explorations et pathologies neuromusculaires, CHU Jean-Minjoz, 3, boulevard Fleming, 25030 Besançon cedex, France. guy.monnier@univ-fcomte.fr
Summary
Botulinum toxin (BT) injections effectively treat hyperhidrosis and sialorrhea by blocking cholinergic transmission. While axillary hyperhidrosis shows the best results, optimal techniques and dosages for all applications require further research.
Area of Science:
- Neurology
- Dermatology
- Otolaryngology
Context:
- Botulinum toxin (BT) is increasingly recognized for its therapeutic potential beyond cosmetic applications.
- Clinical studies suggest BT is effective for hyperhidrosis and sialorrhea.
Purpose:
- To systematically review and summarize the current evaluation of botulinum toxin (BT) for treating hyperhidrosis and sialorrhea.
- To consolidate findings from existing literature and personal experience.
Summary:
- A systematic literature search identified numerous publications on BT for focal hyperhidrosis since 1997, with the best outcomes reported for axillary hyperhidrosis and gustatory sweating.
- BT injections demonstrate effectiveness for palmar and plantar hyperhidrosis, though less frequently studied and presenting technical challenges.
- Emerging literature indicates BT is effective for sialorrhea, reducing saliva production and drooling via parotid and submandibular gland injections, though optimal techniques and dosages are yet to be determined.
Impact:
- Establishes BT as a viable treatment option for hyperhidrosis and sialorrhea with minimal side effects.
- Highlights the need for standardized injection techniques, optimal dosing, and precise targeting for both conditions.
- Identifies palmoplantar hyperhidrosis as a challenging indication requiring further investigation into pain management and efficacy.