The drooling patient: team evaluation and management

Crysdale, William S.; Greenberg, Janice; Koheil, Ruth; Moran, Rod

doi:10.1016/s0165-5876(85)80040-9

Cited by 43 publications

(43 citation statements)

References 3 publications

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“…In children with congenital or acquired oral function incapacity, surgical correction should be stimulated, especially in those above five years of age, in whom neurologic development is more stabilized and much gain from speech therapy is not expected. 1,7 Surgical morbidity is low and average hospital stay time was of two days, in agreement with reports in the literature. 10 The level of motor compromise should not influence surgical decision, having in mind that even totally dependent patients may benefit from the procedure.…”

Section: Discussionsupporting

confidence: 89%

Evolução de 31 crianças submetidas à ressecção bilateral das glândulas submandibulares e ligadura dos ductos parotídeos para controlar a sialorréia

Manrique

Brasil

Ramos

2007

Rev. Bras. Otorrinolaringol.

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Ai m: To evaluate the safety of bilateral submandibular gland excision and parotid duct ligation in order to control drooling in children; to assess its long-term efficacy and complications. Study design: longitudinal cohort. Materials and Methods: Thirty-one children aged 6 to 13 years (7.6 years old in average), with multiple neurological disabilities were submitted to a bilateral submandibular gland excision with parotid duct ligation in order to control ptyalism between December 1999 and December 2005, mean follow up of 36 months. Results: According to Wilkie's success criteria, 87% of children had excellent or good results and insignificant morbidity was insignificant; with temporary parotid edema as the major complication. Conclusion: Bilateral submandibular gland excision with parotid duct ligation were safe to be performed in children, with 87% of success in drooling control.

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Section: Discussionsupporting

confidence: 89%

Evolução de 31 crianças submetidas à ressecção bilateral das glândulas submandibulares e ligadura dos ductos parotídeos para controlar a sialorréia

Manrique

Brasil

Ramos

2007

Rev. Bras. Otorrinolaringol.

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“…Specialists from this centre have functioned as a team in the assessment of patients (Crysdale et al 1985). Management decisions have been made by consensus for this diverse group of neurologically involved patients (i.e.…”

Section: Participantsmentioning

confidence: 99%

“…Analysis of this database indicates the surgical procedures completed annually from 1976 to 1 January 1999 (Fig. 3); this data has been the basis for previous reports (Crysdale et al 1985, Crysdale andWhite 1989). Following an early disappointing experience with tympanic neurectomies, the surgical procedure used beginning in 1978 was SDR.…”

Section: Participantsmentioning

confidence: 99%

Management of drooling in individuals with neurodisability: a surgical experience

Crysdale

Raveh

McCann

et al. 2001

Develop Med Child Neuro

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From 1975 to 1 January 1999, 1103 neurologically involved patients (mean age 13.2 years; 686 males, 417 females) referred with problematic drooling, or sialorrhea, were assessed at a pediatric rehabilitation center by a team consisting of an otolaryngologist, speech pathologist, and a dentist. The initial standard treatment for persistent sialorrhea (in the compliant or aware patient) is oral‐motor training. A group of 522 patients with persistent significant drooling after a minimum of 6 months of oral‐motor training, or profuse drooling in the presence of a low cognitive level, underwent surgery, usually when over 6 years of age. From 1978 to 1 January 1998, the operation of first choice was submandibular duct relocation (SDR), and was completed in a total of 226 patients. Midway through 1988, sublingual gland excision was also completed at the time of submandibular duct relocation (SDRSGE); 249 of these procedures have been completed to January 1st 1999. Those patients who had SDRSGE had significantly fewer complications that required additional surgery than those that had SDR only. However, the impact of surgery on the drooling as evaluated in subsets of both groups (SDR n=115, SDRSGE n=106) was statistically similar. The study of 11 children with salivary gland radionuclitide scans to determine the effect of submandibular duct surgery on gland function was inconclusive. The pattern of oral‐motor function in 26 children studied after SDRSGE surgery suggested that those children with severe impairment of volitional motor function and profuse drooling tended to have a poorer outcome following surgery compared to those with milder impairments.

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“…Anticholinergic drug substances such as Atropine, Benztropine, Glycopyrrolate, and Benzhexol Hydrochloride are some options, which reduce the volume of saliva in the oral cavity by blocking the action of parasympathetic autonomic nervous system on acetylcholine receptors on the salivary glands (Ellies et al, 2006a;Coskun et al, 2007;Bavikatte et al, 2012). Other ways include antihistaminic drugs (Alter, 2010); surgery such as ablation of salivary glands, tympanic neurectomy, transposition or retropositioning of excretory ducts or ligation of excretory ducts (Ellies et al, 2002;Savarese et al, 2004;Manrique et al, 2007); radiotherapy (Bavikatte et al, 2012;Kasarskis et al, 2011;Corso et al, 2011); speech therapy (Crysdale, 1980); techniques of body position, and the "biofeedback" (Tscheng, 2002;Savarese et al, 2004;Bloem et al, 2009;Valencia and Mendoza, 2011).…”

Section: Introductionmentioning

confidence: 99%

Histological and immunohistochemical findings of the action of botulinum toxin in salivary gland: systematic review

2016

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The treatment of sialorrhea is necessary for the constant risks posed by hypersalivation. A new therapeutic option comes up with the application of botulinum toxin in salivary glands. However, little is known about its mechanism of action in glandular tissue. Based on the above, this work had the objective to systematically review the literature about the action of botulinum toxin on submandibular and parotid salivary glands tissues. Electronic search was performed in databases of great relevance for this study (PubMed, SciELO, HighWire, Crossref, Scopus, Science Direct, MEDLINE, OLDMEDLINE, Serials Database, NLM Catalog, LILACS and IBECS). Inclusion and exclusion criteria for articles were established, and a total number of 14 articles were selected and used. There are few publications that clarify how the salivary gland acini behave with application of botulinum toxin. Although, the immunohistochemical findings were consistent among authors, showing weak immunoreactivity in glands treated with botulinum toxin. Histometric data are divergent, requiring more detailed studies to answer the questions about the efficacy and safety of botulinum toxin in salivary glands.Keywords: botulinum toxins, salivary glands, sialorrhea, botulinum toxin type A.Achados histológicos e imunohistoquímicos da ação da toxina botulínica em glândula salivar: revisão sistemática ResumoO tratamento da sialorreia se faz necessário pelos constantes riscos trazidos por este estado de hipersalivação. Uma nova opção terapêutica surge com a aplicação da toxina botulínica em glândulas salivares. Entretanto, pouco se sabe sobre o seu mecanismo de ação no tecido glandular. Com base no exposto, este trabalho teve o objetivo de revisar sistematicamente na literatura a ação da toxina botulínica sobre o tecido das glândulas salivares submandibular e parótida. Foi realizada uma busca eletrônica em bases de dados de grande relevância para este estudo (PubMed, SciELO, HighWire, Crossref, Scopus, Science Direct, MEDLINE, OLDMEDLINE, Serials Database, NLM Catalog, LILACS e IBECS). Foram estabelecidos critérios de inclusão e exclusão para os artigos, e um "n" de 14 trabalhos foram selecionados e utilizados. São poucas as publicações que esclarecem como os ácinos das glândulas salivares se comportam mediante aplicação da toxina botulínica. Apesar de os achados imunohistoquímicos entre os autores serem concordantes, com imunorreatividade mais fracas nas glândulas tratadas com a toxina botulínica, os dados histométricos são divergentes e há questionamentos metodológicos, necessitando de mais estudos pormenorizados para responder as questões sobre a eficácia e segurança da toxina botulínica nas glândulas salivares.Palavras-chave: toxinas botulínicas, glândulas salivares, sialorreia, toxinas botulínicas tipo A.

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The drooling patient: team evaluation and management

Cited by 43 publications

References 3 publications

Evolução de 31 crianças submetidas à ressecção bilateral das glândulas submandibulares e ligadura dos ductos parotídeos para controlar a sialorréia

Evolução de 31 crianças submetidas à ressecção bilateral das glândulas submandibulares e ligadura dos ductos parotídeos para controlar a sialorréia

Management of drooling in individuals with neurodisability: a surgical experience

Histological and immunohistochemical findings of the action of botulinum toxin in salivary gland: systematic review

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