Clinical study of botulinum-A toxin in the treatment of sialorrhea in children with cerebral palsy.
OBJECTIVE
To assess the safety and efficacy of intraglandular (parotid and submandibular) botulinum-A toxin (BTX-A) in the treatment of sialorrhea in children with cerebral palsy (CP).


METHODS
Prospective, open-label, dose-escalation study.


METHODS
Tertiary care Children's Hospital.


METHODS
Twenty-two subjects between 8 and 21 years of age with CP and significant sialorrhea.


METHODS
The first 12 subjects were injected in only the submandibular gland and the second 10 in the submandibular and parotid glands. Injections were performed under ultrasound localization. The first group (divided into 3) received a total of 10, 20, or 30 units of BTX-A. The second group (divided into 3) received a standard of 30 units in the submandibular gland and 20, 30, or 40 units in the parotid glands.


METHODS
Drool quantification using a pre- and postinjection "drool rating scale," dental roll weights, and "drool quotient." Swallowing was evaluated pre- and postinjection with a formal speech therapy evaluation.


RESULTS
All subjects successfully underwent BTX-A injections without local or systemic complications. There were no adverse effects on swallowing. Objective "drool quantification" with dental rolls was extremely difficult in this population. Most indicative of results was the "drool rating" questionnaire and the "drool quotient."


CONCLUSIONS
BTX-A is a potentially safe and promising, minimally invasive treatment for sialorrhea in children with cerebral palsy.
Suskind
Dana L
DL
Department of Otolaryngology, LSU School of Medicine and Children's Hospital of New Orleans, New Orleans, Louisiana, U.S.A.
Tilton
Ann
A
D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000188:drug therapy*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D010306:Parotid Gland / Q000187:drug effects*; D011446:Prospective Studies; D012472:Salivation / Q000187:drug effects; D012798:Sialorrhea / Q000188:drug therapy*; D013363:Submandibular Gland / Q000187:drug effects*
D019274:Botulinum Toxins, Type A