Botulinum toxin versus submandibular duct relocation for severe drooling.

摘要: Aim  Botulinum neurotoxin type A (BoNT-A) has been described as an effective intervention for drooling and is being increasingly adopted. However, its effectiveness compared with established treatments still unknown. We undertook a within-participants observational study to examine this. Method  An historic cohort was formed of 19 children young adults (10 males, nine females) severe who underwent BoNT-A injections followed by surgical re-routing the submandibular duct at least 6 months later. Mean age time admission 11 years 5 months (range 5–17y) mean surgery 14 years 6–23y). Fifteen were diagnosed bilateral cerebral palsy (CP), three unilateral CP, one non-progressive developmental delay. Gross Motor Function Classification System levels following: level I, n=1; II, n=2; III, n=7; IV, n=6; V, n=3). The primary outcome quotient, which assessed before each 8 32 weeks thereafter. multivariate analysis variance repeated measures performed, measurement points within-participant variables. Results  quotient reduced greater extent after than administration (p=0.001). Compared baseline value 28, 8 weeks 10, 4 (p<0.001). Among group treated BoNT-A, showed significant reduction from 30 18 (p=0.02), continued but diminished effect (drooling 22; p=0.05). Interpretation  Both interventions are effective, provides larger longer-lasting effect.