First XXXX : Our experience with intraparotid injections with botulinum toxin type A.

@entity1 @entity1109 @entity158 @entity8976
OBJECTIVES/HYPOTHESIS: First @entity8976 is the sudden onset of acute and severe @entity158 in the parotid region at the initiation of mastication. Although it generally lasts less than a minute, it is disabling for these individuals and leads to a fear of oral intake. It is typically seen after parapharyngeal or deep parotid space surgery. Intraparotid injection of botulinum toxin A (BTA) has been suggested as a treatment for this condition, but there is little supporting literature to this effect. The purpose of this study is to document our experience using this treatment method for first @entity8976 . STUDY DESIGN: Retrospective case review. METHODS: Five @entity1 with first @entity8976 , developed after parapharyngeal space surgery, were treated by multisite injection of BTA into the parotid gland. Between 17.5 and 50 total U of BTA were injected into four or more sites in the parotid region. The @entity1 were then followed up every 4 months. RESULTS: Three of five @entity1 reported a significant improvement in symptoms at the 4-month follow-up visit, although complete resolution was not reported. One @entity1 reported only moderate improvement, and despite two series of injections there was no improvement in one @entity1 , leading us to question our initial diagnosis. CONCLUSIONS: Unilateral BTA injection into the affected parotid gland produces a decrease in the severity of symptoms. It is a safe and viable noninvasive treatment for this difficult to treat condition and may lead to permanent @entity1109 in some @entity1 . LEVEL OF EVIDENCE: 4 Laryngoscope, 2015.
