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Exploring Salivary Gland Complications: Case of Acute Parotitis After Botulinum Toxin Injection for Bruxism
Israel: Recent reports have emerged highlighting botulinum toxin-induced parotitis as a significant postoperative complication following masseter muscle injections. This unexpected adverse effect has raised concerns among practitioners in aesthetic medicine and dentistry, necessitating increased awareness and caution during procedures.
A recent case study has described a case of acute parotitis in a 60-year-old female following Botulinum toxin (BTX) injections to the masseter muscle (to treat bruxism). The botulinum toxin also impacted the parotid gland and facial nerve leading to reduced saliva production and weakness in the corresponding facial muscles.
The case published in the Journal of Oral and Maxillofacial Surgery highlights the possible salivary gland complications after BTX injection into the masticatory muscles.
The case concerns a 60-year-old female who presented to the emergency room (ER) with complaints of swelling and pain in the right side of the face, accompanied by xerostomia, which was initiated a week before her ER visit. The patient indicated that she received a botulinum toxin injection in the masseter muscle three weeks before she visited the ER for her known bruxism. She reported experiencing mild muscle weakness at the right commissure, which had improved a few days before her arrival.
Botulinum toxin injection is a widely used treatment for bruxism; however, there is a lack of literature regarding potential complications affecting the salivary glands. To fill this knowledge gap, Nadav Grinberg, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, and colleagues conducted an electronic search of PubMed and Embase databases to create a literature review to delve into the etiology behind the presented case and suggest potential preventive measures to avoid salivary gland complications.
Key findings:
- Thirty-one articles are reviewed and discussed.
- Currently, there is no consensus on the causes of the mentioned complication.
- Various factors have been proposed, encompassing anatomical, physiological, biological, and physical aspects.
"Various methods have been proposed for the safe injection of botulinum toxin, and enhanced medical training and knowledge are essential to ensure predictable outcomes," the researchers wrote.
In conclusion, while botulinum toxin remains a valuable tool in aesthetic and therapeutic applications, the emergence of parotitis as a postoperative complication underscores the need for vigilance. As more patients seek out these procedures, healthcare providers must remain informed about potential risks and implement strategies to ensure patient safety. Ongoing research and case monitoring will be essential in further understanding this complication and improving clinical outcomes.
Reference:
Grinberg, N., Whitefield, S., Kleinman, S., Frenkel, G., & Peleg, O. (2024). Botulinum Toxin-Induced Parotitis: A Postoperative Complication Following Masseter Muscle Injection. Journal of Oral and Maxillofacial Surgery, 82(5), 525-530. https://doi.org/10.1016/j.joms.2024.02.007
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751