Transtympanic Neurectomies for Control of Drooling

Grewal, D. S.; Hiranandani, N. L.; Rangwalla, Z.A.; Sheode, J.H.

doi:10.1016/s0385-8146(84)80007-3

Cited by 12 publications

(6 citation statements)

References 8 publications

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“…According to Blasco et al [3], this method accomplishes in a highly selective fashion what pharmacological therapy cannot do. The preferred sectioning procedures are the transtympanic chorda tympani and tympanic sectioning procedures, either uni-or bilaterally, and either alone or in combination with another procedure such as excision of one submandibular gland [15,47,48]. Despite high success rates [47], recurrence of drooling in the long term has been reported [49].…”

Section: Surgical Methodsmentioning

confidence: 99%

The Management of Drooling in Children and Patients With Mental and Physical Disabilities: A Literature Review

Hussein¹,

Kershaw²,

Tahmassebi

et al. 1998

Int J Paed Dentistry

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Amongst the duties of the paediatric dentist is the provision of oral care to patients with the problem of drooling. Many, but certainly not all, of these patients have physical and/or learning disabilities. Various methods have been advocated for the management of drooling in the paediatric patient and older patients with disabilities, including behavioural programmes, biofeedback techniques, physiotherapy, biofunctional oral appliances, medication and surgery. It is of paramount importance that the patients and/or carers understand the advantages and disadvantages of any treatment method being considered. The paediatric dentist has an important role to play in explaining the different options to the patients and carers, and in implementing some treatment modalities, particularly non-surgical approaches. Referral to surgical specialists should be seen as 'a last resort' and suggested only if other treatment methods have been exhausted. If pharmacological or surgical treatment is carried out, careful monitoring for the development of dental caries and other problems is essential. The aim of this paper is to provide the paediatric dentist with concise overall knowledge of the causes of drooling and treatment options available.

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Section: Surgical Methodsmentioning

confidence: 99%

The Management of Drooling in Children and Patients With Mental and Physical Disabilities: A Literature Review

Hussein¹,

Kershaw²,

Tahmassebi

et al. 1998

Int J Paed Dentistry

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“…Neurectomy involves sectioning of the chorda tympani nerves, which reduces salivary flow rate. Unfortunately, loss of taste and hearing are possible complications 65, 66. Duct ligation, duct relocation, and gland excision procedures can be done individually or in combination, with reported long‐term success rates in children of over 75% 67–69.…”

Section: Treatment Of Sialorrhea In Pdmentioning

confidence: 99%

Sialorrhea in Parkinson's disease: A review

et al. 2007

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A significant number of patients with Parkinson's disease (PD) experience sialorrhea. This problem can cause social embarrassment, and because saliva pools in the mouth, may lead to aspiration pneumonia. Sialorrhea in PD is thought to be caused by impaired or infrequent swallowing, rather than hypersecretion. Oral medications, botulinum toxin injections, surgical interventions, radiotherapy, speech therapy, and trials of devices may be used to treat sialorrhea in PD, but few controlled trials have been published. This article reviews current knowledge regarding the frequency, etiology, assessment, and treatment of sialorrhea in PD.

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“…Although duct translocation surgery is associated with relatively more complications and higher morbidity, minor surgical risk also attends surgical neurectomies (Wilkie andBrody 1977, Crysdale 1980). Subsequent operations also may be required to augment the original level of control, to manage recurrent drooling, or to treat postoperative complications (Wilkie and Brody 1977, Guerin 1979, Crysdale 1980, Grewal et al 1984. Finally, efficacy often depends on surgical skill (Mullins et al 1979), the operations are essentially irreversible, and procedures that destroy normal tissue could be considered too aggressive for a physiologically benign disorder (Guerin 1979).…”

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confidence: 99%

“…Drooling can be a significant problem for the developmentally disabled, and it has been estimated that 25 to 35 per cent of cerebral-palsied patients drool to varying degrees (Harris and Dignam 1980, Rapp 1980, Winsberg and Camp-Bruno 1982. Because drooling is unhygienic and may predispose to and transmit infection, it can compromise patient care and education (Arnold and Gross 1977, Rapp and Bowers 1979, Grewal et al 1984. It may also impair articulation, interfere with interpersonal relations, diminish self-esteem, and restrict placement and vocational options, especially for those of normal intelligence (Brody 1977, Guerin 1979, Rapp andBowers 1979, Crysdale 1980).…”

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confidence: 99%

“…Treatment strategies aim to decrease the volume of oral saliva by surgery, physiotherapy or pharmacotherapy. Although anticholinergic drugs readily inhibit secretion of saliva by blocking parasympathetic innervation to the salivary glands (Weiner 1985), pharmacotherapy generally has been regarded as either ineffective or impractical because of difficulty in achieving or maintaining control without side-effects (Arnold and Gross 1977, Rapp and Bowers 1979, Grewal et al 1984. However, given the absence of research to assess the efficacy of anticholinergics in controlling drooling, typically they have been dismissed either on the basis of personal experience (Guerin 1979, Rapp and Bowers 1979) or by reference to the opinion of others (Arnold andGross 1977, Michel et al 1977).…”

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confidence: 99%

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Efficacy of Benztropine Therapy for Drooling

Camp-Bruno

Winsberg

Green‐Parsons

et al. 1989

Develop Med Child Neuro

132

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SUMMARY This study assessed the efficacy of synthetic anticholinergic benztropine and incidence of side‐effects in 20 developmentally‐disabled patients with severe drooling. The double‐blind, placebo‐controlled, crossover protocol included one‐week baseline, two‐week placebo and two‐week benztropine conditions (mean dose 3·8mg). A significant decrease in drooling during the benztropine condition relative to placebo was demonstrated and conservative response rates (calculated by deleting placebo responders), ranged up to 65 to 70 per cent. For patients completing the protocol the incidence of side‐effects did not differ across conditions and minor problems such as a dry mouth were eliminated by small dose adjustments. More serious cholinergic side‐effects, which resolved within 24 to 48 hours, necessitated discontinuation of the drug in three patients. This study demonstrates that synthetic anticholinergics can provide an important therapeutic alternative to surgical and behavioral therapies for drooling. RÉSUMÉ Efficacité de la benzatropine synthétique dans le traitement du bavage Cette étude apprécie l'efficacité et l'incidence des effets secondaires d'un anticholinérgique, la benzatropine synthétique, chez vingt sujets en incapacité par retard de développement, qui bavaient beaucoup. Le protocole en double aveugle, contrôle placébo et experimentation croisée comportait une semaine de réference, deux semaines de placébo et deux semaines sous benzatropine (dose moyenne de 3·8 mg). Une diminution significative du bavage sous benzatropine par rapport au placébo fut démontrée avec taux de réponse apprécies conservativement (calculés en supprimant les réponses placébo) atteignant jusqu’à 65 ou 70 pour cent. Chez les sujets à protocole rempli, l'incidence des effets secondaires ne différait pas des conditions croisées et les problèmes mineurs comme la sécheresse de la bouche furent facilement éliminés par de faibles ajustements de dose. Des effets secondaires cholinergiques plus sérieux, disparaissant en 24 à 48 heures, nécessitèrent l'arrêt de traitement chez trois sujets. Cette étude démontre que les anticholinergiques synthétiques peuvent fournir une alternative théiapeutique au traitement chirurgical ou comportemental. ZUSAMMENFASSUNG Der therapeutische Erfolg einer Behandlung mit synthetischem Benztropin beim Speichelfluβ In dieser Studie werden Wirkung und Nebenwirkungen des synthetischen, anticholinergisch wirkenden Benztropin bei 20 behinderten Patienten mit starkem Speichelfluß untersucht. Die Doppelblind‐, Placebo kontrollierte‐, Wechselstudie beinhaltete eine Woche ohne Therapie, zwei Wochen Placebo und zwei Wochen Benztropin (mittlere Dosis 3 · 8mg). Während der Benztropintherapie ließ der Speichelfluß im Vergleich zur Placebobehandlung signifikant nach und der Therapieerfolg lag bei 65 bis 70 Prozent (nachdem die Placebo Responder eliminiert worden waren). Bei den Patienten, die die Studie beendeten, unterschied sich die Häufigkeit von Nebenwirkungen bei den unterschiedlichen Bedingungen nicht und geringe...

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Transtympanic Neurectomies for Control of Drooling

Cited by 12 publications

References 8 publications

The Management of Drooling in Children and Patients With Mental and Physical Disabilities: A Literature Review

The Management of Drooling in Children and Patients With Mental and Physical Disabilities: A Literature Review

Sialorrhea in Parkinson's disease: A review

Efficacy of Benztropine Therapy for Drooling

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