{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T22:05:34Z","timestamp":1769637934362,"version":"3.49.0"},"reference-count":11,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2012,10,24]],"date-time":"2012-10-24T00:00:00Z","timestamp":1351036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>In patients suffering from oral cavity cancer surgical treatment is complex because it is necessary to remove carcinoma and lymph node metastasis (through a radical unilateral or bilateral neck dissection) and to reconstruct the affected area by means of free flaps. The saliva stagnation in the post-operative period is a risk factor with regard to local complications. Minor complications related to saliva stagnation (such as tissue maceration and wound dehiscence) could become major complications compromising the surgery or the reconstructive outcome. In fact the formation of oro-cutaneous fistula may cause infection, failure of the free flap, or the patient\u2019s death with carotid blow-out syndrome. Botulinum injections in the major salivary glands, four days before surgery, temporarily reduces salivation during the healing stage and thus could reduce the incidence of saliva-related complications. Forty three patients with oral cancer were treated with botulinum toxin A. The saliva quantitative measurement and the sialoscintigraphy were performed before and after infiltrations of botulinum toxin in the major salivary glands. In all cases there was a considerable, but temporary, reduction of salivary secretion. A lower rate of local complications was observed in the post-operative period. The salivary production returned to normal within two months, with minimal side effects and discomfort for the patients. The temporary inhibition of salivary secretion in the post-operative period could enable a reduction in saliva-related local complications, in the incidence of oro-cutaneous fistulas, and improve the outcome of the surgery as well as the quality of residual life in these patients.<\/jats:p>","DOI":"10.3390\/toxins4110956","type":"journal-article","created":{"date-parts":[[2012,10,24]],"date-time":"2012-10-24T11:00:57Z","timestamp":1351076457000},"page":"956-961","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Botulinum Toxin A for Oral Cavity Cancer Patients: In Microsurgical Patients BTX Injections in Major Salivary Glands Temporarily Reduce Salivary Production and the Risk of Local Complications Related to Saliva Stagnation"],"prefix":"10.3390","volume":"4","author":[{"given":"Bartolo","family":"Corradino","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, Plastic Surgery Unit, University of Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Di Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Plastic Surgery Unit, University of Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Moschella","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Plastic Surgery Unit, University of Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2012,10,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.oraloncology.2005.10.018","article-title":"Incidence of oral and oropharyngeal cancer in the United Kingdom","volume":"42","author":"Conway","year":"2006","journal-title":"Oral Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/S1368-8375(99)00070-6","article-title":"Comparison of cancers of the oral cavity and pharynx worldwide: Etiological clues","volume":"36","author":"Franceschi","year":"2000","journal-title":"Oral Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1097\/01.PRS.0000076219.62225.07","article-title":"Critical oropharyngocutaneous fistulas after microsurgical head and neck reconstruction: Indications for management using the tissueplug technique","volume":"112","author":"Salgado","year":"2003","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/S1353-8020(00)00073-0","article-title":"Quantitative assessment of parkinsonian sialorrhea and results of treatment with botulinum toxin","volume":"7","author":"Friedman","year":"2001","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/S0887-8994(02)00381-8","article-title":"Botulinum toxin A as a treatment for excessive drooling in children","volume":"27","author":"Bothwell","year":"2002","journal-title":"Pediatr. Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/S0168-6054(03)00103-X","article-title":"Sialorrhea, hyperhidrosis and botulinum toxin (In French)","volume":"46","author":"Monnier","year":"2003","journal-title":"Ann. Readapt. Med. Phys."},{"key":"ref_7","first-page":"118","article-title":"Botulinum toxin in the treatment of autonomic nervous system disorders","volume":"15","author":"Arad","year":"2004","journal-title":"Head Neck Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1053\/joms.2003.50086","article-title":"Up-to-date report of botulinum toxin therapy in patients with drooling caused by different etiologies","volume":"61","author":"Ellies","year":"2003","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.clineuro.2003.10.012","article-title":"Ultrasound-guided versus \u2018\u2018blind\u2019\u2019 intraparotid injections of botulinum toxin-A for the treatment of sialorrhoea in patients with Parkinson\u2019s disease","volume":"106","author":"Dogu","year":"2004","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0385-8146(99)00026-7","article-title":"Noninvasive scintigraphic method to quantify unstimulated secretions from individual salivary glands","volume":"26","author":"Malpani","year":"1999","journal-title":"Auris Nasus Larynx"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"156","DOI":"10.3109\/00016480902968094","article-title":"Botulinum toxin in preparation of oral cavity for microsurgical reconstruction","volume":"130","author":"Corradino","year":"2010","journal-title":"Acta Oto-Laryngol."}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/4\/11\/956\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T21:53:05Z","timestamp":1760219585000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/4\/11\/956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10,24]]},"references-count":11,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2012,11]]}},"alternative-id":["toxins4110956"],"URL":"https:\/\/doi.org\/10.3390\/toxins4110956","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,10,24]]}}}