Onabotulinumtoxin-A injections into the salivary glands for spinal muscle atrophy type I: A prospective case series of four patients

Objective To investigate the safety and efficacy of Onabotulinum Toxin-A (BTX-A) injection to the salivary glands under ultrasound guidance for the treatment of sialorrhea in patients with spinal muscular atrophy type I (SMA I). Design: Prospective case series with four patients with SMA I who received BTX-A injection to parotid and submandibular glands for sialorrhea as part of clinical care. All four patients received validated surveys for measuring drooling, including objective measures of number of bib changes, and number of mouth wipes before injection and 4-6 weeks after injection. Research was limited to survey completion. Scales included the Drooling Severity and Frequency Scale and the Drooling Impact Scale as well as a new scale used in our clinic, the Posterior Drooling Scales looking at coughing/choking and number of aspiration pneumonias. Results: There were no adverse events. All four patients showed clinically significant improvements. The improvement in drooling using the DIS was statistically significant (Paired-t test, t=3.243, P=0.048). All patients improved with number of mouth wipes. Conclusion Ultrasound guided BTX-A injections to the salivary glands may be a safe and effective method of decreasing drooling in patients with SMA I. Corresponding Author: Hannah Aura Shoval, Children's Specialized Hospital, 1135 Broad Street, Clifton NJ, 07013, Email: hshoval@childrens-specialized.org This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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