Ultrasound-guided Fire Needle Acupuncture For Treating Sialorrhea In Tracheotomized Patients

Sialorrhea is a syndrome characterized by the overflow of saliva from the oral cavity, resulting from either hypersecretion of the salivary glands or dysphagia. As a common sequela in stroke patients, sialorrhea can induce feelings of low self-esteem, perioral and facial inflammation, aspiration pneumonia, and significantly increase healthcare costs. Current clinical management primarily relies on anticholinergic medications or botulinum toxin to inhibit saliva production. However, these treatments offer limited efficacy and are associated with adverse effects such as xerostomia and dysphagia. Consequently, non-pharmacological therapies, including acupuncture in traditional Chinese medicine and rehabilitation training, have emerged as effective alternatives. Fire needling, a traditional Chinese medicine technique, possesses dual properties: needle stimulation and a thermal effect. It is characterized by rapid operation, no needle retention, and transient pain. For patients with suboptimal response to pharmacotherapy, we developed an ultrasound-guided fire needling method to reduce salivary volume and salivation frequency while avoiding adverse effects. Details are described in the text. Ultrasound guidance allows preoperative visualization of muscular and glandular tissues and their surrounding structures, facilitating precise insertion of the fire needle into the targeted glandular or muscular layers, thereby optimizing treatment efficacy and safety.