Treatment of sialorrhea in children with Cerebral Palsy: A double-blind placebo controlled trial

Drooling quantification: Correlation of different techniques

“…Furthermore, objective scales are time-consuming and impractical in the clinical settings (Alrefai, Aburahma, & Khader, 2009;Gok et al, 2013;Hay & Penn, 2011).…”

Clinical and Laryngotracheoscopic Evaluation of Children with Cerebral Palsy Using Intraparotid Injections of Botulinum Toxin Type A for Drooling Control

“…Therefore, ultrasound must be performed concomitantly with the application of botulinum toxin in this gland [10]. Most studies do not apply toxin in the submandibular because there is this dependence on the ultrasound.…”

Management of sialorrhoea in neurologically impaired children

“…Oral health knowledge is considered to be an essential prerequisite retardation and cerebral palsy are implicated. The factors that contribute to drooling in children with CP include an inefficient coordination of the oral phase of swallowing and poor lip closure (1) . Other factors that might contribute to drooling include muscle hypotonia, macroglossia, dental malocclusion, abnormal posture, and impaired nasal airway patency (4) .…”

“…Sialorrhea (drooling) is the unintentional loss of saliva and other oral contents from the mouth (1) .This condition is normal in infants, but usually stops by 15 to 18 months of age.Sialorrhea after four years of age generally is considered to be pathologic.Physical and psychosocial complications of sialorrhea range from mild and inconvenient symptoms to severe problems that can have a significant negative impact on quality of life overall prevalence of significant chronic drooling in childhood is put at up to 0.6%.The commonest population group with severe and persisting difficulty is children with quadriplegic cerebral palsy where the prevalence rate is as high as 30-53% (3) . Reported treatment options have included behavioral modification therapy, oral or topical anticholinergic medications, surgical excision of salivary glands or duct relocation, and chemodenervation with botulinum toxin (1) .…”

“…Reported treatment options have included behavioral modification therapy, oral or topical anticholinergic medications, surgical excision of salivary glands or duct relocation, and chemodenervation with botulinum toxin (1) . Despite of many treatment options, definitive conclusions are difficult to draw because of different outcome measures used in the various studies.…”