Benefits of botulinum toxin associated to swallowing therapy in patients with severe dysphagia

Revista da Sociedade Brasileira de Fonoaudiologia

Universidade Federal de São Paulo, São Paulo, Brasil¹  Rodrigues, Katia Alonso¹  Chiari, Brasília Maria¹  Manrique, Dayse¹  Menezes, Fernanda Teixeira¹  Gonçalves, Maria Inês Rebelo¹  Oliveira Neto, Isabella Christina de¹ 

关键词: Deglutition disorders/rehabilitation;    Botulinum toxins;    type A/therapeutic use;    Rehabilitation;    Saliva/drug effects;    Salivary glands;    Case studies;   

DOI  :  10.1590/S1516-80342012000200021

来源: Sociedade Brasileira de Fonoaudiologia

【 摘 要 】

 Case report with the aim to characterize the benefits of botulinum toxin injection into salivary glands in association with swallowing therapy in patients with severe dysphagia. The medical records of five neurological patients (four male and one female, aged between 17 and 70 years) who exclusively used alternative feeding were analyzed. Four patients were tracheostomized. Inclusion criterion was to present severe dysphagia associated to clinical manifestations of drooling and/or sialorrhea with significant aspiration of saliva, restricting the improvement in swallowing rehabilitation. Data were collected before and after intervention associated with botulinum toxin injection, regarding the following aspects: mobility and strength of oropharyngeal structures (lips, tongue and cheeks), laryngeal elevation, severity degree of dysphagia, use of alternative tube feeding and tracheostomy. After swallowing therapy, four patients showed improvement in mobility and strength of the lips, tongue, cheeks and larynx. Four patients presented functional swallowing and one of them modified had the severity degree of dysphagia changed. Therefore, most patients were able to receive exclusive oral feeding, and only one remained on combination of gastrostomy and oral feeding with pasty consistence. All tracheostomized patients had the tracheostomy cannula removed. The study showed that the treatment described contributed to swallowing rehabilitation, reintroduction of oral feeding, and withdrawal ofthe tracheostomy cannula.

【 授权许可】

Unknown