Intraoperative botulinum toxin injection for superficial partial parotidectomy: A prospective pilot study

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Surgical Innovation

Background:

• Sialocele and salivary fistula are common, troublesome complications following parotidectomy.
• Existing methods to prevent these postoperative saliva-related complications lack definitive clinical trial data.
• Prophylactic use of botulinum toxin (BTX) for parotidectomy has not been previously assessed in clinical trials.

Purpose of the Study:

• To investigate the safety and efficacy of intraoperative botulinum toxin (iBTX) injection in partial superficial parotidectomy (PSP).
• To evaluate iBTX as a potential preventative measure for saliva-related complications after PSP.

Main Methods:

• A pilot study involving prospective recruitment of patients undergoing PSP with iBTX injection (iBTX group, n=36).
• Retrospective review of consecutive patients who underwent PSP without iBTX (control group, n=54).
• Comparison of complication rates (sialocele, salivary fistula, facial palsy) and postoperative drainage volume between the two groups.

Main Results:

• No permanent facial palsy was observed in either group.
• The incidence of sialocele was significantly lower in the iBTX group (2.8%) compared to the control group (20.4%, P < .05).
• Total postoperative drainage volume was significantly reduced in the iBTX group (55.0 mL) versus the control group (116.6 mL, P < .001).

Conclusions:

• Intraoperative BTX injection appears to be safe and effective in reducing sialocele incidence and postoperative drainage following PSP.
• iBTX may serve as a valuable option for preventing saliva-related complications after partial superficial parotidectomy.
• Further clinical trials are warranted to confirm these findings.