Parasympathetic nerve section for control of sialorrhea

Michel, Ross G.; Johnson, Kara A.; Patterson, Carl N.

doi:10.1097/00006534-197709000-00071

Cited by 7 publications

(8 citation statements)

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“…Surgical procedures involve either parasympathetic denervation of the salivary glands by tympanic plexus and/or chorda tympani neurectomy to decrease salivary flow (Arnold and Gross 1977, Michel et al 1977, Crysdale 1980, or posterior translocation to the pharynx of submandibular or parotid duct orifices, the latter typically in conjunction with submandibular resection (Brody 1977, Guerin 1979. Both approaches reportedly yield long-term success rates as high as 80 to 85 per cent (Arnold andGross 1977, Wilkie andBrody 1977), but controlled research is rare and observations often are anecdotal.…”

mentioning

confidence: 99%

Efficacy of Benztropine Therapy for Drooling

Camp-Bruno

Winsberg

Green‐Parsons

et al. 1989

Develop Med Child Neuro

132

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SUMMARY This study assessed the efficacy of synthetic anticholinergic benztropine and incidence of side‐effects in 20 developmentally‐disabled patients with severe drooling. The double‐blind, placebo‐controlled, crossover protocol included one‐week baseline, two‐week placebo and two‐week benztropine conditions (mean dose 3·8mg). A significant decrease in drooling during the benztropine condition relative to placebo was demonstrated and conservative response rates (calculated by deleting placebo responders), ranged up to 65 to 70 per cent. For patients completing the protocol the incidence of side‐effects did not differ across conditions and minor problems such as a dry mouth were eliminated by small dose adjustments. More serious cholinergic side‐effects, which resolved within 24 to 48 hours, necessitated discontinuation of the drug in three patients. This study demonstrates that synthetic anticholinergics can provide an important therapeutic alternative to surgical and behavioral therapies for drooling. RÉSUMÉ Efficacité de la benzatropine synthétique dans le traitement du bavage Cette étude apprécie l'efficacité et l'incidence des effets secondaires d'un anticholinérgique, la benzatropine synthétique, chez vingt sujets en incapacité par retard de développement, qui bavaient beaucoup. Le protocole en double aveugle, contrôle placébo et experimentation croisée comportait une semaine de réference, deux semaines de placébo et deux semaines sous benzatropine (dose moyenne de 3·8 mg). Une diminution significative du bavage sous benzatropine par rapport au placébo fut démontrée avec taux de réponse apprécies conservativement (calculés en supprimant les réponses placébo) atteignant jusqu’à 65 ou 70 pour cent. Chez les sujets à protocole rempli, l'incidence des effets secondaires ne différait pas des conditions croisées et les problèmes mineurs comme la sécheresse de la bouche furent facilement éliminés par de faibles ajustements de dose. Des effets secondaires cholinergiques plus sérieux, disparaissant en 24 à 48 heures, nécessitèrent l'arrêt de traitement chez trois sujets. Cette étude démontre que les anticholinergiques synthétiques peuvent fournir une alternative théiapeutique au traitement chirurgical ou comportemental. ZUSAMMENFASSUNG Der therapeutische Erfolg einer Behandlung mit synthetischem Benztropin beim Speichelfluβ In dieser Studie werden Wirkung und Nebenwirkungen des synthetischen, anticholinergisch wirkenden Benztropin bei 20 behinderten Patienten mit starkem Speichelfluß untersucht. Die Doppelblind‐, Placebo kontrollierte‐, Wechselstudie beinhaltete eine Woche ohne Therapie, zwei Wochen Placebo und zwei Wochen Benztropin (mittlere Dosis 3 · 8mg). Während der Benztropintherapie ließ der Speichelfluß im Vergleich zur Placebobehandlung signifikant nach und der Therapieerfolg lag bei 65 bis 70 Prozent (nachdem die Placebo Responder eliminiert worden waren). Bei den Patienten, die die Studie beendeten, unterschied sich die Häufigkeit von Nebenwirkungen bei den unterschiedlichen Bedingungen nicht und geringe...

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mentioning

confidence: 99%

Efficacy of Benztropine Therapy for Drooling

Camp-Bruno

Winsberg

Green‐Parsons

et al. 1989

Develop Med Child Neuro

132

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“…Die transtympanale Neurektomie des N. tympanicus [ 233 ] führte häufi g zu Rezidiven und vor allem auch zu einem Verlust der Geschmacksempfi ndung, evtl. sogar zur Xerostomie [ 234 ] . Sie wird aus diesem Grund heutzutage nicht mehr durchgeführt.…”

Section: Die Chirurgische Therapie Der Sialorrhoeunclassified

Speicheldrüsenerkrankungen im Kindesalter

Iro

Zenk

2014

Laryngorhinootologie

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Salivary gland diseases in children are rare, apart from viral--induced diseases. Nevertheless, it is essential for the otolaryngologist to recognize these uncommon findings in children and adolescents and to diagnose and initiate the proper treatment. The present work provides an overview of the entire spectrum of congenital and acquired diseases of the salivary glands in childhood and adolescence. The current literature was reviewed and the results discussed and summarized. Besides congenital diseases of the salivary glands in children, the main etiologies of viral and bacterial infections, autoimmune diseases and tumors of the salivary glands were considered. In addition to the known facts, new developments in diagnostics, imaging and therapy, including sialendoscopy in obstructive diseases and chronic recurrent juvenile sialadenitis were taken into account. In addition, systemic causes of salivary gland swelling and the treatment of sialorrhoea were discussed. Although salivary gland diseases in children are usually included in the pathology of the adult, they differ in their incidence and some-times in their symptoms. Clinical diagnostics and especially the surgical treatment are influenced by a stringent indications and a less invasive strategy. Due to the rarity of tumors of the salivary glands in children, it is recommended to treat them in a specialized center with greater surgical experience. Altogether the knowledge of the differential diagnoses in salivary gland diseases in children is important for otolaryngologists, to indicate the proper therapeutic approach.

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“…These operations essentially aim to reduce saliva production, change the outflow of saliva or involve a combination of the two. Transtympanic neurectomy of the tympanic nerve [ 233 ] often leads to recurrence and especially to a loss of taste sensation or possibly even to xerostomia [ 234 ]. For this reason, it is nowadays no longer performed.…”

Section: Sialorrhoeamentioning

confidence: 99%