Service ORL et Chirurgie Cervico-Faciale Pédiatrique, Hôpital Jeanne de Flandre, Avenue Eugène Avinée, 59000 Lille, France.
Service ORL et Chirurgie Cervico-Faciale Pédiatrique, Hôpital Jeanne de Flandre, Avenue Eugène Avinée, 59000 Lille, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2022 Mar;139(2):77-81. doi: 10.1016/j.anorl.2021.06.007. Epub 2021 Jun 30.
The main objective of this study was to assess tolerance of botulinum toxin A injection into the salivary glands under local anesthesia in a pediatric population. Secondary endpoints comprised efficacy and side-effects.
A retrospective observational study included children treated between January 2013 and March 2020 for sialorrhea and/or pharyngeal salivary congestion. Children were identified from the botulinum toxin A injection database. The study included 162 injection sessions in 55 children. Injections were performed under local anesthesia with nitrous oxide, after clinical location of the site. Epidemiological and clinical data, injection tolerance on the FLACC scale, treatment response and complications were recorded.
For submandibular gland injections, pain was absent in 81 cases, mild in 64, moderate in 4 and intense in 1. In parotid gland injections, pain was absent in 45 cases, mild in 89, moderate in 17 and intense in 1. Injection tolerance was significantly poorer (P<0.005) in parotid than submandibular glands. Seventy-seven percent of the injections had a positive effect on sialorrhea. Fifteen patients presented transient adverse events: mainly dysphagia and paradoxical increase in sialorrhea.
Salivary gland botulinum toxin A injections in under local anesthesia were well-tolerated, safe and effective for children with sialorrhea and/or pharyngeal salivary congestion.
本研究的主要目的是评估局部麻醉下将肉毒毒素 A 注射到唾液腺中在儿科人群中的耐受性。次要终点包括疗效和副作用。
一项回顾性观察研究纳入了 2013 年 1 月至 2020 年 3 月期间因流涎症和/或咽唾液淤积而接受治疗的儿童。从肉毒毒素 A 注射数据库中识别出这些儿童。该研究纳入了 55 名儿童的 162 次注射。在局部麻醉下使用一氧化二氮进行注射，在临床定位部位后进行。记录了流行病学和临床数据、FLACC 量表上的注射耐受性、治疗反应和并发症。
对于下颌下腺注射，81 例无疼痛，64 例轻度疼痛，4 例中度疼痛，1 例剧烈疼痛。对于腮腺注射，45 例无疼痛，89 例轻度疼痛，17 例中度疼痛，1 例剧烈疼痛。腮腺注射的耐受性明显较差（P<0.005）。77%的注射对流涎症有积极影响。15 名患者出现短暂的不良反应：主要是吞咽困难和唾液分泌增多的矛盾增加。
局部麻醉下唾液腺肉毒毒素 A 注射在儿童中耐受性良好、安全且有效，可用于治疗流涎症和/或咽唾液淤积。
