Botulinum toxin - an overview of applications in otorhinolaryngology

Abstract

Background: Botulinum toxin (BT) is primarily known for its aesthetic applications, but there are many opportunities to use the toxin for the prevention and treatment of various other conditions. BT is not very widespread in otolaryngology practice, but can be effective in many diseases. The TB mechanism is related to the blockade of the muscular plate or the glandular one and is therefore effective in various muscular disorders and autonomic secretory disorders. Aim: The purpose of this work is to review the applications of botulinum toxin in otolaryngology. Material and methods: Scientific publications on the Pubmed platform were reviewed using the keywords: „botulinum toxin” and „otolaryngology”, and time descriptors were set for 2012–2022. Results: Botulinum toxin is an effective and safe treatment that causes minor and transient side effects, and its duration of action varies depending on the condition for which it is used (from 3–6 months on average, up to several years in Lucia Frey syndrome). This is the first-line treatment in Lucia Frey syndrome, laryngeal dystonia and synkinesis. The most common otorhinolaryngological indications, discussed in the following paper, in which botulinum toxin is one component of treatment include Lucia Frey syndrome, salivary fistulas, excessive salivation syndromes, laryngeal dystonia, vocal tremor, vocal granuloma, synkinesis in facial nerve palsy, dysphagia, and an interesting new indication for the use of the toxin in the treatment of resistant rhinitis. The following paper reviews the treatment protocols with botulinum toxin for the aforementioned indications and includes information such as management, dosage, injection sites. The study provides an introduction for ENTs interested in introducing botulinum toxin into their practice, as well as updates practical information for those already practicing. Conclusions: Botulinum toxin is a safe and effective treatment for a wide range of non-aesthetic indications in otorhinolaryngology.