Khan Waqas Ullah, Campisi Paolo, Nadarajah Sanjeevan, Shakur Yaseer Abdul, Khan Nasir, Semenuk Dan, McCann Cathy, Roske Lisa, McConney-Ellis Sharon, Joseph Melissa, Parra Dimitri, Amaral Joao, John Philip, Temple Michael, Connolly Bairbre
Faculty of Medicine, University of Toronto, Ontario, Canada.
Arch Otolaryngol Head Neck Surg. 2011 Apr;137(4):339-44. doi: 10.1001/archoto.2010.240. Epub 2011 Jan 17.
To report (1) our experience with botulinum toxin A injections into the salivary glands of pediatric patients with sialorrhea, (2) the clinical outcomes of these interventions, and (3) the associated complication rates.
Retrospective cohort study.
Urban pediatric hospital and pediatric rehabilitation center.
Forty-five neurologically impaired children.
Patients received botulinum toxin A intrasalivary injections between January 2004 and May 2008 at the Hospital for Sick Children in Toronto, Ontario, Canada. All patients received sedation or general anesthesia for their botulinum toxin A injections, which were performed using ultrasonographic guidance.
Posttreatment assessments included the duration of effect, patient complications, saliva consistency, caregiver willingness to repeat the treatment, caregiver satisfaction with the treatment, and caregiver overall assessment of the child's posttreatment quality of life.
Forty-five subjects received a total of 91 botulinum toxin A treatments. The mean (SD) duration of effect was 4.6 (5.2) months. Duration of effect (log transformed) was significantly negatively associated with saliva quantity (P = .02), and there was a positive association with both increasing age and female sex, although neither reached statistical significance (P = .08 for each). Seven of the 24 documented complications were major, according to the Society of Interventional Radiology Classification System for Complications by Outcome scale. Thirty-six of the caregivers reported that this treatment improved the child's quality of life (80%).
Ultrasonographically guided botulinum toxin A injections into the salivary glands are safe and efficacious in the management of sialorrhea in children with neurologic disorders.
报告（1）我们对患有流涎症的儿科患者唾液腺注射A型肉毒杆菌毒素的经验，（2）这些干预措施的临床结果，以及（3）相关并发症发生率。
回顾性队列研究。
城市儿科医院和儿科康复中心。
45名神经功能受损儿童。
2004年1月至2008年5月期间，患者在加拿大多伦多病童医院接受了唾液腺内A型肉毒杆菌毒素注射。所有患者在注射A型肉毒杆菌毒素时均接受了镇静或全身麻醉，注射在超声引导下进行。
治疗后评估包括效果持续时间、患者并发症、唾液黏稠度、护理人员重复治疗的意愿、护理人员对治疗的满意度以及护理人员对患儿治疗后生活质量的总体评估。
45名受试者共接受了91次A型肉毒杆菌毒素治疗。平均（标准差）效果持续时间为4.6（5.2）个月。效果持续时间（对数转换后）与唾液量显著负相关（P = 0.02），与年龄增长和女性性别呈正相关，尽管两者均未达到统计学意义（每项P = 0.08）。根据介入放射学会并发症按结果分类系统，24例记录的并发症中有7例为严重并发症。36名护理人员报告称，这种治疗改善了患儿的生活质量（80%）。
超声引导下对唾液腺注射A型肉毒杆菌毒素在治疗神经功能障碍儿童流涎症方面是安全有效的。
