Management of drooling in children with cerebral palsy: A French survey

Chaléat-Valayer, Emmanuelle; Porte, M.; Buchet-Poyau, Karine; Roumenoff-Turcant, F.; D’Anjou, M.-C.; Boulay, C.; Bernard, J.-C.; Touzet, Sandrine

doi:10.1016/j.ejpn.2016.04.010

Cited by 20 publications

(15 citation statements)

References 27 publications

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“…Therefore, to conclude, noninvasive management needs more consistent and longitudinal support and is therefore time consuming, which might be a challenge for practice areas. For example, Chaleat‐Valayer et al () conducted a survey of 75 professionals who work with patients who present with sialorrhoea. The results demonstrate that although the majority of professionals prescribe noninvasive management therapies, only 25% prescribe them systematically.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of noninvasive and invasive sialorrhoea management

Varley

Denieffe

O’Gorman

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To review published literature pertaining to the management of sialorrhoea while also highlighting the significance of the multidisciplinary approach. Background Sialorrhoea is a common and troublesome problem among certain neurological patients. It is distressing for patients and caregivers, and can be challenging for healthcare professionals. Various sialorrhoea management approaches have been documented. However, there is no clear consensus on best management practices. Therefore, it is necessary to systematically review and synthesise various approaches so as to provide an understanding of the efficacy of management approaches. Design Systematic literature review using PRISMA checklist (see Appendix S1). Method Five databases (ScienceDirect, Wiley Online Library, CINAHL, Cochrane Library and PubMed) were searched (years 2001–2018) following inclusion criteria. Out of 1,294 identified records, 29 studies met the inclusion criteria. Results Various management approaches identified, ranging from noninvasive, such as speech therapy aiming to enhance swallowing behaviour, to invasive treatment including anticholinergic medication, botulinum toxin injection and surgical techniques. However, in the majority of cases, there is no scientific evidence‐based management protocol leading to favourable results, and the evidence base for intervention effectiveness remains weak. Conclusions The multifactor nature of sialorrhoea and its associated complications presents challenges for the medical care team. None of the management strategies stand alone as the best modality; therefore, it is proposed that management strategies follow a multidisciplinary approach to meet the diverse needs of patients. Relevance to clinical practice A comprehensive understanding of different sialorrhoea management approaches will enable healthcare professionals to identify the signs and symptoms regarding sialorrhoea, and to assist in effective management implementation. This will help to improve the management of sialorrhoea, hence, to improve quality of life of patients and provide formative scope to the development of an integrated care pathway.

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Section: Resultsmentioning

confidence: 99%

A systematic review of noninvasive and invasive sialorrhoea management

Varley

Denieffe

O’Gorman

et al. 2019

Journal of Clinical Nursing

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“…The scopolamine patch is expensive and inaccessible for some patients. This drug is contraindicated in patients with heart problems, glaucoma, prostatic hypertrophy, and pyloric obstruction …”

Section: Discussionmentioning

confidence: 99%

Treatment of drooling with scopolamine in pediatric ICU: A case series report

Cacita

Freua

Ortega

et al. 2018

Special Care in Dentistry

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Drooling is a condition that affects patients with difficulties in swallowing, being common in patients with mental, neurological or dysphagic deficiency. This condition is difficult to diagnose, as it is often confused with sialorrhea, and in many cases we have a hyposalivation scenario. Its diagnosis is subjective, which is why scales should be used for the standardization of the evaluation of the degree of drooling before and after the proposed treatment, as the Thomas-Stonell and Greenberg scale. It causes problems such as perioral infections, rashes, wet clothing, leading to social embarrassment, and may be a risk factor for respiratory infections caused by asymptomatic aspiration of saliva. It presents several treatments, among them the pharmacological one, that is dependent of the clinical picture of each patient that must be evaluated daily. This article refers to a series of reports of cases of children in mechanical ventilation by tracheostomy, hospitalized, with clinical diagnosis of drooling, and clinical improvement with the use of scopolamine by gastrostomy, without intercurrences during its use. The objective of this study is to show other professionals the importance of drooling management, and to expose the adopted behavior in the described cases, providing reduction of respiratory infections and improvement of the clinical and social complications resulting from drooling.

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“…The efficacy of BoNT treatment with serotype B (rimabotulinumtoxinB) has also been studied, as well as the effect of various BoNT-A preparations (abobotulinumtoxinA, incobo-tulinumtoxinA, onabotulinumtoxinA). The effects of all the toxins have been reproduced in case studies as well as in controlled studies, some of which were placebo controlled [1,[76][77][78][79][80][81].…”

Section: Botulinum Toxin In Treatment Of Sialorrheamentioning

confidence: 99%

Therapy of Sialorrhea with Botulinum Neurotoxin

et al. 2019

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Botulinum neurotoxin (BoNT) is considered the treatment of choice for various symptoms and diseases such as focal dystonia and focal spasticity. The effects of BoNT on the salivary glands have also been known for years, but their use was limited because of a lack of approval studies. Now the indication of sialorrhea is approved in some countries for incobotulinumtoxinA, such as the USA and Europe, and therapy could also become the treatment of choice. According to the pivotal study, a dose of 100 units of incobotulinumtoxinA, which is divided into the parotid and submandibular glands, is recommended. RimabotulinumtoxinB is approved in the USA only. To define the value of this therapy, we must consider anatomy, physiology, and available therapies. Therapy includes conservative measures such as functional dysphagia therapy, oral or transdermal application of anticholinergics, and, in selected cases, radiotherapy and surgical procedures. A combination of different approaches is optional. On the basis of the evidence and clinical experience, BoNT injections will be the first line of pharmacotherapy for chronic sialorrhea.

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Management of drooling in children with cerebral palsy: A French survey

Cited by 20 publications

References 27 publications

A systematic review of noninvasive and invasive sialorrhoea management

A systematic review of noninvasive and invasive sialorrhoea management

Treatment of drooling with scopolamine in pediatric ICU: A case series report

Therapy of Sialorrhea with Botulinum Neurotoxin

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