Local experience using botulinum toxin for the management of post-parotidectomy fistulas and recurrent parotitis

Background: Botulinum toxin (BTx) reduces the production of saliva in salivary glands. Literature supporting the use of BTx in post-parotidectomy fistulas and recurrent parotitis is expanding, however use in Australia has been limited. We report our experience with BTx for the management of post-parotidectomy fistulas and recurrent parotitis. Methods: Case series. Patients were injected with onabotulinumtoxinA into the affected salivary gland or residual salivary tissue. Results: We present nine cases of parotid gland pathology successfully managed with BTx. Five patients were managed for post-parotidectomy fistulas, with four reporting complete resolution. Four patients were managed for recurrent parotitis, all reporting reduced symptoms. In those prescribed regular antibiotics, there was a reduction in use after BTx injection. Two patients had mild dry eyes after the injections, with no other side effects. Conclusions: We advocate for the early use of BTx in the management of post-parotidectomy fistulas and recurrent parotitis based on available data and our nine cases.