Norderyd Johanna, Graf Jonas, Marcusson Agneta, Nilsson Karolina, Sjöstrand Eva, Steinwall Gunilla, Ärleskog Elinor, Bågesund Mats
National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
CHILD, Swedish Institute for Disability Research, Jönköping University, Jönköping, Sweden.
Int J Paediatr Dent. 2017 Jan;27(1):22-29. doi: 10.1111/ipd.12219. Epub 2015 Dec 27.
Drooling can be a severe disability and have high impact on daily life. Reversible treatment is preferable.
To analyse whether sublingual administration of atropine eyedrops is a useful reversible treatment option for severe drooling in children with disabilities.
The study had a prospective, single-system research design. The participants served as their own controls. The study period was 3 weeks without treatment, 4 weeks with atropine eyedrop solution 10 mg/mL one drop a day followed by 4 weeks of one drop twice a day. Parents' rating of their child's drooling was assessed on a 100-mm VAS, and unstimulated salivary secretion rate measurement was performed together with notations about side effects and practicality.
Parents' VAS assessment of drooling decreased from a median (range) of 74 (40-98) at baseline to 48 (18-88) (P = 0.05) and 32 (12-85) (P = 0.004) after 4 weeks of atropine once a day and another 4 weeks of atropine twice a day, respectively (n = 11). Unstimulated salivary secretion rates decreased from baseline to end of study (P = 0.032). Several parents complained about difficult administration. No irreversible side effects were noted.
Sublingual atropine eyedrops may be an alternative for treatment of severe drooling in children with disabilities.
流口水可能是一种严重的残疾,对日常生活有很大影响。可逆性治疗更为可取。
分析舌下含服阿托品眼药水是否是治疗残疾儿童严重流口水的一种有效的可逆性治疗选择。
该研究采用前瞻性单系统研究设计。参与者自身作为对照。研究期为3周无治疗期,4周每天一滴10mg/mL阿托品眼药水,随后4周每天两滴。通过100mm视觉模拟量表评估家长对孩子流口水情况的评分,并进行非刺激性唾液分泌率测量,同时记录副作用和实用性。
家长对流口水的视觉模拟量表评估从基线时的中位数(范围)74(40 - 98)分别降至阿托品每天一次治疗4周后的48(18 - 88)(P = 0.05)和阿托品每天两次治疗4周后的32(12 - 85)(P = 0.004)(n = 11)。非刺激性唾液分泌率从基线降至研究结束时(P = 0.032)。几位家长抱怨给药困难。未观察到不可逆的副作用。
舌下含服阿托品眼药水可能是治疗残疾儿童严重流口水的一种替代方法。