Submandibular duct ligation after botulinum neurotoxin A treatment of drooling in children with cerebral palsy

Developmental Medicine and Child Neurology
Stijn BekkersFrank J A van den Hoogen

Abstract

To assess: (1) the effect on drooling of bilateral submandibular duct ligation as surgical therapy after the administration of submandibular botulinum neurotoxin A (BoNT-A) for excessive drooling and (2) the predictive value of treatment success with BoNT-A on treatment success after bilateral submandibular duct ligation. This was a within-participant retrospective observational study in which 29 children with severe drooling (15 males, 14 females) received BoNT-A treatment at a mean age of 9 years 6 months (SD 2y 5mo), followed by bilateral submandibular duct ligation at a mean age of 10 years 11 months (SD 2y 4mo). Fifteen children were diagnosed with cerebral palsy (CP), with 12 children classified in Gross Motor Function Classification System levels IV and V. The 14 children without CP had non-progressive developmental disorders. The primary drooling severity outcomes were the Visual Analogue Scale (VAS; subjective assessment) and drooling quotient (objective assessment). Measurements were taken before each intervention and again at 8 and 32 weeks. The VAS was significantly lower after bilateral submandibular duct ligation at follow-up compared to BoNT-A treatment (mean difference -33, p≤0.001; 95% confidence interval [CI]=...Continue Reading

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Citations

Jul 25, 2020·Developmental Medicine and Child Neurology·Stijn BekkersFrank J A van den Hoogen
Sep 23, 2020·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·Francesco De PeppoSonia Battaglia
Mar 28, 2021·Developmental Medicine and Child Neurology·Stijn BekkersFrank Ja Van Den Hoogen
Sep 3, 2021·International Journal of Pediatric Otorhinolaryngology·Stijn BekkersFrank J A van den Hoogen

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