Efficacy of Botulinum Toxin Type A in the Treatment of Post Surgical Parotid Fistula-A Systematic Review

Salivary fistula is a troublesome complication of parotid surgery. The treatment of this condition requires weeks before effect becomes evident. Botulinum toxin injection is a newer treatment modality. This systematic review sheds light on the efficacy of Botulinum toxin in treatment of post surgical parotid fistula. Studies comparing botulinum toxin with the other available treatment modalities as well as those studies solely using botulinum toxin are taken into consideration in the review. Electronic data search of Pub Med, Google Scholar, EMBASE, Institutional Library, Email to authors and manual search of various journals. Finally, 9 studies were included in qualitative synthesis with a total of 25 estimates. Botulinum toxin type A injections are effective in reducing the flow of saliva in treatment of post operative parotid fistula, thereby aiding in healing of the fistula. The studies had a varying variety of dose, route of administration and cycles of administration per case, making it difficult to evaluate the efficacy of Botulinium toxin in the treatment of parotid fistula. Further research focusing on streamlining the dose and delivery of the toxin must be conducted in order to establish definitive guidelines.