Secondary effects of botulinum toxin injections into salivary glands for the management of pediatric drooling.
This study aimed to assess the secondary benefits and adverse effects of botulinum toxin A injections into the parotid and submandibular glands in children with developmental disability and to determine whether these effects are related to reduction in drooling. Twenty-six children were injected (14 boys and 12 girls; mean age, 11 years 3 months). The Drooling Impact Scale and a secondary effects questionnaire covering aspects of eating, speech, saliva management, and sleep, were administered to the main carer at specific times before and after injection. Group mean preinjection and postinjection item and domain scores were compared using paired t tests. Change scores were calculated; individually categorized as improvement, no change, or deterioration; and related to change in drooling scores using linear regression analysis. Over 4 weeks, evidence of improvement was seen for the entire group with respect to drooling (P < 0.001), eating (P = 0.05), speech (P = 0.04), and sleep (P = 0.01), but not saliva management. Conversely, a minority of families reported worsening of eating skills after the injections that was directly related to lack of improvement in drooling. Because a minority of children unpredictably experience temporary adverse effects after botulinum toxin A injections into the salivary glands, swallowing function and nutritional status should be taken into account before proceeding with treatment.
Developmental Disability and Rehabilitation Research, Murdoch Children’s Research Institute, Flemington Rd, Parkville,Victoria 3052, Australia. sue.reid@mcri.edu.au
Susan Margaret
SM
Reid
Janet E
JE
Walstab
David
D
Chong
Christine
C
Westbury
Dinah S
DS
Reddihough
D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000503:physiopathology; D002648:Child; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007267:Injections; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D009752:Nutritional Status; D010306:Parotid Gland; D012798:Sialorrhea / Q000188:drug therapy* / Q000503:physiopathology; D013363:Submandibular Gland; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A