Adjuvant Role of Botulinum Toxin A in the Management of Wounds Accompanied by Parotid Gland or Duct Injuries

Background: Parotid gland or duct injuries may occur after facial trauma or surgical procedures around the parotid gland. Such injuries often cause saliva to leak into the wound, and as a result, the autolytic enzymes in the saliva can delay wound healing. To promote wound healing in such cases, salivary leakage must be stopped until the wound has completely healed. Though there are several known measures for preventing salivary leakage, including compressive dressings, suction drainage, food restriction, and anticholinergic drugs, they often yield unsatisfactory results. This study aimed to evaluate the clinical efficacy of botulinum toxin A in stopping salivary secretions and inducing wound healing in wounds accompanied by parotid gland or duct injuries. Methods: A retrospective study was conducted to evaluate the efficacy of botulinum toxin A for treating salivary leakage due to parotid gland or duct injuries. Five patients were treated between 2011 and 2016, three of whom received postoperative injections with a total dose of 30–40 units of botulinum toxin A. One of the other two patients was injected with the same amount of botulinum toxin A preoperatively, and the other received an intraoperative injection. Results: All five patients showed an abrupt decrease of salivary leakage on the 3rd day after toxin injection and satisfactory wound healing without untoward side effects. Conclusion: This study demonstrates the critical role played by botulinum toxin A in management of wounds complicated by abnormal leakage of saliva, when the parotid gland or duct is injured.