Abstract：
OBJECTIVE: To investigate the effectiveness of botulinum toxin in the salivary glands of patients with neurological impairment and drooling and its impact on the quality of life.
METHODS: This systematic review was registered with the International Prospective Register of Systematic Reviews (CRD 42,023,435,242) and conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. An electronic search was performed in the PubMed/MEDLINE, Embase, Scopus, Cochrane Library, and clinical trial databases until August 2023, no language restriction. Cohort studies and randomized clinical trials of patients diagnosed with drooling and neurological impairment who used botulinum toxin on the salivary gland were included, which evaluated subjective quality of life parameters. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist and Risk of Bias 2 tools. The certainty of the evidence was analyzed using the Grading of Recommendations Assessment, Development, and Evaluation approach.
RESULTS: Eight studies involving 317 patients were included. All studies, through subjective parameters, suggested the effectiveness of botulinum toxin in reducing drooling, resulting in an improvement in the quality of life. Three studies demonstrated improvements in swallowing and four in cases of respiratory diseases. Two clinical trials had a high risk of bias, whereas one had low risk. The five cohort studies that were evaluated had a high risk of bias. The certainty of the evidence was considered low.
CONCLUSIONS: Based on the patient/caregivers\' perception of improvement in drooling, dysphagia, and respiratory symptoms, it can be inferred that botulinum toxin application reduces subjective drooling in neurologically compromised patients. Its impact contributes to the general well-being and quality of life.
CONCLUSIONS: Injection of botulinum toxin into the salivary glands can be considered an alternative technique to surgical or medicinal approaches in reducing drooling. It is effective, less invasive and without significant side effects. It promotes a positive impact on the well-being and quality of life of neurological patients.
METHODS: This systematic review was registered with the International Prospective Register of Systematic Reviews (CRD 42,023,435,242) and conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. An electronic search was performed in the PubMed/MEDLINE, Embase, Scopus, Cochrane Library, and clinical trial databases until August 2023, no language restriction. Cohort studies and randomized clinical trials of patients diagnosed with drooling and neurological impairment who used botulinum toxin on the salivary gland were included, which evaluated subjective quality of life parameters. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist and Risk of Bias 2 tools. The certainty of the evidence was analyzed using the Grading of Recommendations Assessment, Development, and Evaluation approach.
RESULTS: Eight studies involving 317 patients were included. All studies, through subjective parameters, suggested the effectiveness of botulinum toxin in reducing drooling, resulting in an improvement in the quality of life. Three studies demonstrated improvements in swallowing and four in cases of respiratory diseases. Two clinical trials had a high risk of bias, whereas one had low risk. The five cohort studies that were evaluated had a high risk of bias. The certainty of the evidence was considered low.
CONCLUSIONS: Based on the patient/caregivers\' perception of improvement in drooling, dysphagia, and respiratory symptoms, it can be inferred that botulinum toxin application reduces subjective drooling in neurologically compromised patients. Its impact contributes to the general well-being and quality of life.
CONCLUSIONS: Injection of botulinum toxin into the salivary glands can be considered an alternative technique to surgical or medicinal approaches in reducing drooling. It is effective, less invasive and without significant side effects. It promotes a positive impact on the well-being and quality of life of neurological patients.
摘要：
目的：探讨肉毒毒素在神经功能缺损和流口水患者唾液腺中的作用及其对生活质量的影响。
方法：本系统评价在国际前瞻性系统评价注册中心（CRD42,023,435,242）注册，并使用系统评价和荟萃分析的首选报告项目进行。在PubMed/MEDLINE进行了电子搜索，Embase,Scopus,科克伦图书馆,和临床试验数据库到2023年8月，没有语言限制。纳入了对唾液腺使用肉毒杆菌毒素的诊断为流口水和神经功能缺损的患者的队列研究和随机临床试验。评估主观生活质量参数。使用JoannaBriggs研究所关键评估清单和偏差风险2工具评估偏差风险。使用建议等级评估对证据的确定性进行分析，发展,和评价方法。
结果：纳入了涉及317名患者的8项研究。所有研究,通过主观参数，表明肉毒杆菌毒素在减少流口水方面的有效性，从而提高了生活质量。三项研究表明，吞咽功能有所改善，而呼吸系统疾病则有四项。两项临床试验有很高的偏倚风险，而一个风险低。被评估的五项队列研究具有较高的偏倚风险。证据的确定性被认为很低。
结论：基于患者/护理人员对流口水改善的看法，吞咽困难,和呼吸道症状，可以推断,肉毒杆菌毒素的应用减少了神经系统受损患者的主观流口水.它的影响有助于总体福祉和生活质量。
结论：向唾液腺注射肉毒杆菌毒素可以被认为是减少流口水的手术或药物方法的替代技术。它是有效的，侵入性较小，没有明显的副作用。它促进了对神经系统患者的福祉和生活质量的积极影响。
方法：本系统评价在国际前瞻性系统评价注册中心（CRD42,023,435,242）注册，并使用系统评价和荟萃分析的首选报告项目进行。在PubMed/MEDLINE进行了电子搜索，Embase,Scopus,科克伦图书馆,和临床试验数据库到2023年8月，没有语言限制。纳入了对唾液腺使用肉毒杆菌毒素的诊断为流口水和神经功能缺损的患者的队列研究和随机临床试验。评估主观生活质量参数。使用JoannaBriggs研究所关键评估清单和偏差风险2工具评估偏差风险。使用建议等级评估对证据的确定性进行分析，发展,和评价方法。
结果：纳入了涉及317名患者的8项研究。所有研究,通过主观参数，表明肉毒杆菌毒素在减少流口水方面的有效性，从而提高了生活质量。三项研究表明，吞咽功能有所改善，而呼吸系统疾病则有四项。两项临床试验有很高的偏倚风险，而一个风险低。被评估的五项队列研究具有较高的偏倚风险。证据的确定性被认为很低。
结论：基于患者/护理人员对流口水改善的看法，吞咽困难,和呼吸道症状，可以推断,肉毒杆菌毒素的应用减少了神经系统受损患者的主观流口水.它的影响有助于总体福祉和生活质量。
结论：向唾液腺注射肉毒杆菌毒素可以被认为是减少流口水的手术或药物方法的替代技术。它是有效的，侵入性较小，没有明显的副作用。它促进了对神经系统患者的福祉和生活质量的积极影响。
