How Botox jabs can even help stroke victims
QFOR several years I’ve had too much saliva, causing drooling. This is embarrassing but my GP says nothing can be done. Name and address supplied.
AThis must be hard for you but please be reassured there are possible treatments available.
Excessive production of saliva, also known as hypersalivation (or in medicine, ‘ sialorrhea’) typically causes drooling, as you have experienced. it is usually the result of poor co-ordination of the many muscles involved in swallowing — and in many cases there is also an increase in saliva production.
it can be a side-effect of medications, including clozapine, a tranquilliser. But the most common cause i s nerve malfunction or damage affecting the muscles involved in swallowing, for instance as a result of a disorder that’s affected brain function, such as a stroke.
Possible treatments include anticholinergic drugs however, this group of drugs can be poorly tolerated by older people as they can cause sideeffects such as confusion.
Another option is an injection of botulinum toxin (or Botox) into the main salivary glands. some patients may experience di f f i c ul t y in swallowing f ollowing the injections, but that resolves after a few weeks.
i suggest speaking to your GP about being referred to a skill ed neurologist or a maxillofacial specialist to carry out this procedure.
QI HAD a vitrectomy with gas bubble in January to fix a macular hole in my eye, but it didn’t work. My consultant is now recommending a repeat operation using a heavy oil tamponade instead. How successful is it?
John Evans, Forest of Dean, Glos.
ATHE operation you had is used to treat retinal detachment, which can lead to a macular hole. When the retina, the photosensitive layer at the back of the eye, becomes detached, you need immediate surgery to repair it. A vitrectomy is the first stage — removing the vitreous gel, the thick fluid that fills the part of the eye behind the lens and maintains the eye’s shape.
The retina is reattached to the wall of the eyeball with cryotherapy, where a very cold probe triggers inflammation that ensures the retina stays attached (the vitreous gel itself reforms over time).
‘Tamponade’ refers to the technique where a tiny gas bubble is left to press the retina in place while the inflammatory process occurs. slowly gas is absorbed and replaced naturally by the watery fluid found in the eye.
if the reattachment hasn’t worked, one option is a repeat procedure using heavy silicone oil for tamponade.
This has to be removed while the gas bubble does not.
But it can potentially damage the optic nerve and trigger inflammation that damages the retina.
however, in a study of 115 cases, the retina completely re-attached in nearly 83 per cent of patients using an oil tamponade. in just over 17 per cent, the retina detached again. The figures say it all, and i hope — after further consultation — you go ahead with it and restore your vision.