Learning Center: Ultrasound Guided Salivary Gland Injections for the Treatment of Sialorrhea

Botulinum toxin injections are approved for the treatment of sialorrhea. Physiatrists commonly see patients with sialorrhea which can result in difficulty managing secretions and skin breakdown. Other oral or subcutaneous treatments can be ineffective or not tolerated due to side effects, most commonly sedation and constipation. Ultrasound guidance can improve safety, avoiding surrounding vascular structures and muscles, as well as efficacy by optimizing injection of the target gland. Physiatrists commonly encounter patients with sialorrhea, and already have baseline knowledge of botulinum toxin injections. This session offers further training and provides an opportunity for physiatrists to develop another skill, which they can use to treat this patient population. Instructors will review relavent anatomy of the targeted salivary glands, the submandibular and parotid glands and their surrounding structures and anatomic landmarks. Instructors will demonstrate patient, physician, and probe positioning for identification of the glands. Discussions include tips for improving ease of injection and the use of the two FDA approved toxins for the treatment of sialorrhea.