van Eck Reva M, Orriëns Lynn B, Delsing Corinne P A, van den Hoogen Frank J A, Erasmus Corrie E, van Hulst Karen
Department of Paediatrics, Division of Paediatric Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital, Nijmegen, the Netherlands.
Faculty of Medical Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
Dev Med Child Neurol. 2025 May;67(5):656-664. doi: 10.1111/dmcn.16131. Epub 2024 Oct 24.
To evaluate negative effects on oral motor function after concurrent submandibular and parotid (four-gland) botulinum neurotoxin A (BoNT-A) injections as a treatment for paediatric drooling.
This was a retrospective cohort study of 125 children (median age 7 years 7 months [interquartile range 4 years 5 months]) with developmental disabilities, including cerebral palsy, treated with four-gland injections. Most children (90.4%) were previously exposed to submandibular injections. Frequency, severity, and duration of negative effects on oral motor function (i.e. saliva swallowing, eating, drinking, articulation) were evaluated and compared to a reference cohort treated with submandibular injections.
Negative effects on oral motor function were reported in 45 children (36.0%), predominantly manifesting as eating-related problems (64.4%). Most negative effects (62.2%) were classified as mild and resolved within 4-weeks post-injunction (53.3%). Compared to the reference cohort, frequency (36.0% vs 33.0%) and duration (53.3% vs 53.6% resolving within 4 weeks) of negative effects were comparable, although problems were more often moderately severe (33.3% vs 10.1%).
While negative effects on oral motor function were relatively common after four-gland BoNT-A injections, most problems were mild and resolved promptly. No substantial differences to a reference cohort treated with submandibular injections were observed, although further research should establish the generalizability of these findings in a treatment-naive population. Nevertheless, when submandibular injections prove ineffective, clinicians can confidently consider four-gland injections.
评估同时进行下颌下腺和腮腺（四腺体）肉毒杆菌神经毒素A（BoNT-A）注射作为小儿流涎治疗方法时对口腔运动功能的负面影响。
这是一项对125名发育障碍儿童（中位年龄7岁7个月[四分位间距4岁5个月]）进行的回顾性队列研究，这些儿童包括脑瘫患者，均接受了四腺体注射治疗。大多数儿童（90.4%）此前曾接受过下颌下腺注射。评估了对口腔运动功能（即唾液吞咽、进食、饮水、发音）的负面影响的频率、严重程度和持续时间，并与接受下颌下腺注射治疗的参考队列进行比较。
45名儿童（36.0%）报告了对口腔运动功能的负面影响，主要表现为与进食相关的问题（64.4%）。大多数负面影响（62.2%）被分类为轻度，并在注射后4周内得到缓解（53.3%）。与参考队列相比，负面影响的频率（36.0%对33.0%）和持续时间（4周内缓解的比例为53.3%对53.6%）相当，尽管问题更常为中度严重（33.3%对10.1%）。
虽然四腺体BoNT-A注射后对口腔运动功能的负面影响相对常见，但大多数问题是轻度的且迅速得到缓解。与接受下颌下腺注射治疗的参考队列相比，未观察到实质性差异，尽管进一步的研究应确定这些发现在未接受过治疗的人群中的普遍性。然而，当下颌下腺注射证明无效时，临床医生可以放心地考虑四腺体注射。
