Use of Bottox for the Treatment of Sialorrhea (Evaluated by Ultra Sound)

The normal salivary secretion which is a bout 1.5 - 2 Liters dialy which corns from the major salivary glands ( parotid, submandibular and lingual glands) which give about 95% of saliva while minor salivary gland ( in the palate, bucal mucosa, floor of the mouth and lips) which give about 5% of saliva. Sialorrhea or excessive salivation is an uncommon condition, many factors have been implicated in this condition: 1- There is group of patients who report complaints of drooling, however, no obvious clinical evidence of excessive saliva production is observed. peronality analysis has suggested that the complaint of sialorrhea may be associated with high levels of neuroticism and tendency to dissimulate. 2- Some drugs like antipsychotic agents especially clozapine and cholinergic agonists used to treat dementia of Alzeimer and myasthenia gravis. 3- Neurological disorders such as cerebral palsy, parkinson's disease or amyotrophic lateral sclerosis but in these disorders, the drooling not caused by over production of saliva but by poor neuro muscular control. Aim of this study: To evaluate the efficiency of Bottox for the treatment of this condition and used in the submandibular salivary gland (because it give about 70% of saliva)