Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Paediatric Neurology, Nijmegen, The Netherlands.
Eur J Paediatr Neurol. 2012 Mar;16(2):126-31. doi: 10.1016/j.ejpn.2011.06.002. Epub 2011 Jul 23.
The treatment of drooling is important to families that experience the daily impact and research to elucidate clinical factors that play a role in the outcome of drooling treatment should be encouraged.
To define clinical factors that influence therapy outcome of submandibular Botulinum Toxin (BoNT-A) injections for drooling.
Prospectively collected data of 128 children with cerebral palsy were evaluated; 80 spastic and 48 dyskinetic movement disorder, mostly Gross Motor Function Classification System III and higher; over 70% had an IQ <70. In addition, 23 fully ambulant children with exclusively intellectual disability were treated for drooling by ultrasound-guided injections of BoNT-A into the submandibular glands. Salivary flow rates and drooling quotients were measured at baseline and at 8 weeks after injection. Extensive information about the oral motor performance was gathered. Successful clinical response was defined as a 50% reduction of the baseline Drooling Quotient; 85 children were responsive to BoNT-A and 66 children unresponsive.
Five nominated clinical factors that possibly could influence saliva reduction (head position, lip seal, voluntary control over the tongue, control of voluntary movement functions, and mental age) did not influence the responsiveness to BoNT-A.
Other variables need to be considered to predict the outcome of BoNT-A treatment. This article describes the first attempt to reveal the contribution of body functions and structures to the outcome of BoNT-A submandibular injections.
流口水的治疗对经历日常影响的家庭很重要，应该鼓励研究阐明在流口水治疗结果中起作用的临床因素。
确定影响颏下肉毒毒素（BoNT-A）注射治疗流口水疗效的临床因素。
前瞻性收集 128 例脑瘫儿童的数据进行评估；80 例痉挛型和 48 例运动障碍型，大多为粗大运动功能分类系统 III 级及以上；超过 70%的智商<70。此外，23 名完全能行走的智力障碍儿童通过颏下腺超声引导 BoNT-A 注射治疗流口水。在基线和注射后 8 周测量唾液流量和流口水比值。收集了广泛的口腔运动表现信息。成功的临床反应定义为流口水比值降低 50%；85 例儿童对 BoNT-A 有反应，66 例无反应。
可能影响唾液减少的五个指定临床因素（头部位置、唇封、舌头的自主控制、自主运动功能控制和心理年龄）不影响 BoNT-A 的反应性。
需要考虑其他变量来预测 BoNT-A 治疗的结果。本文首次尝试揭示身体功能和结构对 BoNT-A 颏下注射结果的贡献。
