The aim of this study was to determine whether botulinum toxin A (BTX-A) injected into the parotid and submandibular salivary glands of children aged 6 to 16 years with cerebral palsy (CP) and relative sialorrhoea significantly decreases their drooling and improves their quality of life. Twenty children (10 males, 10 females; mean age 10y 1mo SD 3y 8mo; range 6y 1mo-16y 7mo) with CP, identified as having significant daily drooling (scoring at least 6 on drooling frequency/severity scales) were recruited. BTX-A (2U/kg; maximum 70U) was injected under sedation, using ultrasound guidance (1.4U/kg and 0.6U/kg divided between parotid and submandibular glands respectively). Nineteen children completed the study: 15 with spastic quadriplegia (Gross Motor Function Classification System GMFCS Level V); one with dystonia (GMFCS Level V); one with hemiplegia (GMFCS Level II); and two with a mixed pattern of CP (GMFCS Levels III and V). Drooling was assessed by five methods at baseline, and 4 and 12 weeks after injection. Qualitative assessment of drooling frequency and severity scores showed statistically significant reductions at 4 weeks (p<0.001) and 12 weeks (p=0.006). Qualitative assessment of quality of life scores (rated by parents and teachers separately) also significantly improved (p<0.001 and p=0.023 respectively). Quantitative assessments showed that the number of bibs/scarves changed per day was significantly reduced at 4 weeks (p<0.001). There was no side effect from the injections themselves; 89\% of parents and children wished for further intrasalivary BTX-A injections in the future. We conclude that percutaneous intrasalivary BTX-A injections into the parotid and submandibular salivary glands can reduce drooling in children with CP and relative sialorrhoea, leading to an improvement in their quality of life.
%0 Journal Article
%1 Banerjee2006
%A Banerjee, K. J.
%A Glasson, C.
%A O'Flaherty, S. J.
%D 2006
%J Dev Med Child Neurol
%K Adolescent; Botulinum Tox; Cerebral Palsy; Child; Dose-Response Relationship, Drug; Female; Humans; Injections; Male; Neuromuscular Agents; Parotid Gland; Prospective Studies; Quality of Life; Sialorrhea; Submandibular Treatment Outcome; in Type A
%N 11
%P 883--887
%R 10.1017/S0012162206001939
%T Parotid and submandibular botulinum toxin A injections for sialorrhoea in children with cerebral palsy.
%U http://dx.doi.org/10.1017/S0012162206001939
%V 48
%X The aim of this study was to determine whether botulinum toxin A (BTX-A) injected into the parotid and submandibular salivary glands of children aged 6 to 16 years with cerebral palsy (CP) and relative sialorrhoea significantly decreases their drooling and improves their quality of life. Twenty children (10 males, 10 females; mean age 10y 1mo SD 3y 8mo; range 6y 1mo-16y 7mo) with CP, identified as having significant daily drooling (scoring at least 6 on drooling frequency/severity scales) were recruited. BTX-A (2U/kg; maximum 70U) was injected under sedation, using ultrasound guidance (1.4U/kg and 0.6U/kg divided between parotid and submandibular glands respectively). Nineteen children completed the study: 15 with spastic quadriplegia (Gross Motor Function Classification System GMFCS Level V); one with dystonia (GMFCS Level V); one with hemiplegia (GMFCS Level II); and two with a mixed pattern of CP (GMFCS Levels III and V). Drooling was assessed by five methods at baseline, and 4 and 12 weeks after injection. Qualitative assessment of drooling frequency and severity scores showed statistically significant reductions at 4 weeks (p<0.001) and 12 weeks (p=0.006). Qualitative assessment of quality of life scores (rated by parents and teachers separately) also significantly improved (p<0.001 and p=0.023 respectively). Quantitative assessments showed that the number of bibs/scarves changed per day was significantly reduced at 4 weeks (p<0.001). There was no side effect from the injections themselves; 89\% of parents and children wished for further intrasalivary BTX-A injections in the future. We conclude that percutaneous intrasalivary BTX-A injections into the parotid and submandibular salivary glands can reduce drooling in children with CP and relative sialorrhoea, leading to an improvement in their quality of life.
@article{Banerjee2006,
abstract = {The aim of this study was to determine whether botulinum toxin A (BTX-A) injected into the parotid and submandibular salivary glands of children aged 6 to 16 years with cerebral palsy (CP) and relative sialorrhoea significantly decreases their drooling and improves their quality of life. Twenty children (10 males, 10 females; mean age 10y 1mo [SD 3y 8mo]; range 6y 1mo-16y 7mo) with CP, identified as having significant daily drooling (scoring at least 6 on drooling frequency/severity scales) were recruited. BTX-A (2U/kg; maximum 70U) was injected under sedation, using ultrasound guidance (1.4U/kg and 0.6U/kg divided between parotid and submandibular glands respectively). Nineteen children completed the study: 15 with spastic quadriplegia (Gross Motor Function Classification System [GMFCS] Level V); one with dystonia (GMFCS Level V); one with hemiplegia (GMFCS Level II); and two with a mixed pattern of CP (GMFCS Levels III and V). Drooling was assessed by five methods at baseline, and 4 and 12 weeks after injection. Qualitative assessment of drooling frequency and severity scores showed statistically significant reductions at 4 weeks (p<0.001) and 12 weeks (p=0.006). Qualitative assessment of quality of life scores (rated by parents and teachers separately) also significantly improved (p<0.001 and p=0.023 respectively). Quantitative assessments showed that the number of bibs/scarves changed per day was significantly reduced at 4 weeks (p<0.001). There was no side effect from the injections themselves; 89\% of parents and children wished for further intrasalivary BTX-A injections in the future. We conclude that percutaneous intrasalivary BTX-A injections into the parotid and submandibular salivary glands can reduce drooling in children with CP and relative sialorrhoea, leading to an improvement in their quality of life.},
added-at = {2014-07-19T17:53:25.000+0200},
author = {Banerjee, K. J. and Glasson, C. and O'Flaherty, S. J.},
biburl = {https://www.bibsonomy.org/bibtex/2e07030633e416618ef71d302f7310df6/ar0berts},
doi = {10.1017/S0012162206001939},
groups = {public},
interhash = {77b9a4f93f355892c8b54d68b6e6523b},
intrahash = {e07030633e416618ef71d302f7310df6},
journal = {Dev Med Child Neurol},
keywords = {Adolescent; Botulinum Tox; Cerebral Palsy; Child; Dose-Response Relationship, Drug; Female; Humans; Injections; Male; Neuromuscular Agents; Parotid Gland; Prospective Studies; Quality of Life; Sialorrhea; Submandibular Treatment Outcome; in Type A},
month = Nov,
number = 11,
pages = {883--887},
pii = {S0012162206001939},
pmid = {17044954},
timestamp = {2014-07-19T18:01:13.000+0200},
title = {Parotid and submandibular botulinum toxin A injections for sialorrhoea in children with cerebral palsy.},
url = {http://dx.doi.org/10.1017/S0012162206001939},
username = {ar0berts},
volume = 48,
year = 2006
}