Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
Laryngoscope. 2024 Jul;134(7):3012-3017. doi: 10.1002/lary.31277. Epub 2024 Jan 31.
Sialorrhea, also known as drooling, hypersalivation, or ptyalism, has a significant impact on the medical and psychosocial well-being of children. Onabotulinum toxin A (BoNT-A) is the most commonly used botulinum toxin worldwide for the treatment of sialorrhea in children.
To conduct a comprehensive systematic review and meta-analysis to assess the clinical efficacy and potential adverse effects of BoNT-A as a treatment for drooling in children.
Cochrane, Embase, and Medline databases were systematically searched (up to May 2023). Out of 535 identified publications, 20 were found eligible for inclusion. A systematic review and meta-analysis were performed to determine the efficacy of BoNT-A treatment in children in reducing the frequency and severity of drooling.
Out of the 20 studies included, a meta-analysis was conducted on the complete dataset of eight studies involving 131 patients. BoNT-A was found to significantly decrease the severity of drooling in patients with sialorrhea (standardized mean difference [SMD], -2.07; 95% confidence interval [CI], -2.91 to -1.23; p < 0.0001) when compared with the conditions before injections using random-effects models. Six studies out of 20 reported dysphagia as an adverse effect after injection. Other side effects included thickness of saliva and pain at the site of injection.
BoNT-A is a clinically effective therapy that improves drooling severity in children with sialorrhea. Although there were some adverse side effects reported, they were transient and not severe. Future studies are needed to further evaluate the best techniques and to identify the ideal dosages required to achieve the optimal outcomes. Laryngoscope, 134:3012-3017, 2024.
流涎，又称流口水、唾液分泌过多或涎溢，对儿童的身体健康和心理健康有重大影响。肉毒杆菌毒素 A（BoNT-A）是全球最常用于治疗儿童流涎的肉毒杆菌毒素。
进行全面的系统评价和荟萃分析，评估 BoNT-A 治疗儿童流涎的临床疗效和潜在不良反应。
系统检索 Cochrane、Embase 和 Medline 数据库（截至 2023 年 5 月）。在 535 篇已识别的文献中，有 20 篇符合纳入标准。进行系统评价和荟萃分析，以确定 BoNT-A 治疗儿童减少流涎频率和严重程度的疗效。
在纳入的 20 项研究中，对 8 项研究的完整数据集（涉及 131 名患者）进行了荟萃分析。与注射前相比，BoNT-A 显著降低了流涎患者的流涎严重程度（标准化均数差 [SMD]，-2.07；95%置信区间 [CI]，-2.91 至 -1.23；p < 0.0001），采用随机效应模型。20 项研究中的 6 项报告了注射后吞咽困难作为不良反应。其他副作用包括唾液变厚和注射部位疼痛。
BoNT-A 是一种临床有效的治疗方法，可改善流涎儿童的流涎严重程度。尽管有一些不良反应报告，但它们是短暂的，并不严重。未来的研究需要进一步评估最佳技术，并确定实现最佳结果所需的理想剂量。喉科学杂志，134：3012-3017，2024。
