-
American Journal of Otolaryngology 2024Sialorrhea or drooling can result in physical and psychosocial complications, such as aspiration and social isolation. Treatment options include botulinum toxin into the...
INTRODUCTION
Sialorrhea or drooling can result in physical and psychosocial complications, such as aspiration and social isolation. Treatment options include botulinum toxin into the salivary glands and 4-duct ligation (i.e., simultaneous ligation of the bilateral parotid and submandibular ducts). This systematic review aimed to compare the efficacy and complication rates of botulinum toxin and 4-duct ligation for the treatment of drooling in children.
METHODS
Following PRISMA guidelines, PubMed, Embase, Web of Science, and Cochrane Library were searched from inception through June 17, 2021 for studies examining the efficacy of botulinum toxin or 4-duct ligation for drooling in children. Data were summarized by pooled counts, percentages, and means. Complication rates were compared by a chi-squared test.
RESULTS
A total of 22 studies (n = 606) examining botulinum toxin and 5 studies (n = 124) examining 4-duct ligation were included. From 12 botulinum toxin studies (n = 211), mean drooling frequency and severity scores was 7.5 at baseline. Mean difference from baseline was -2.6 (n = 92) at 4 weeks follow-up, -2.1 at 8 weeks (n = 41), -2.1 at 12 weeks (n = 56), and - 2.1 at 16 weeks (n = 58). From 4 4-duct ligation studies (n = 103), mean baseline drooling frequency and severity score was 8.4. Mean difference was -3.7 at mean follow-up of 35.6 months (n = 103). Eighteen botulinum studies (n = 343) recorded 53 (15.5 %) complications, including thickened saliva (n = 9), dysphagia (n = 4), and cheek abscesses (n = 4). Four 4-duct ligation studies (n = 108) recorded 25 (23.1 %) complications, including parotid gland swelling (n = 4), aspiration pneumonia (n = 3), and oxygen desaturation (n = 3). There was no statistically significant difference in complication rates between botulinum toxin and four-duct ligation (p = 0.065).
CONCLUSION
Botulinum toxin injection and 4-duct ligation are both effective in improving sialorrhea in children and have comparable complication rates.
Topics: Child; Humans; Sialorrhea; Botulinum Toxins, Type A; Parotid Gland; Saliva; Salivary Ducts; Treatment Outcome; Submandibular Gland
PubMed: 38043299
DOI: 10.1016/j.amjoto.2023.104119 -
Saudi Medical Journal Jan 2022To evaluate the diagnostic utility of self-collected saliva in coronavirus desease-19 (COVID-19) screening procedures. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the diagnostic utility of self-collected saliva in coronavirus desease-19 (COVID-19) screening procedures.
METHODS
A total of 6 databases were reviewed from their inception until August 2021. Sensitivity and specificity were measured by extracting items (true-positive, true-negative, false-positive and false-negative) from each paper. We evaluated the diagnostic accuracy based on Quality Assessment of Diagnostic Accuracy Studies, version 2.
RESULTS
A total of 41 studies were included in the final analysis. The diagnostic odds ratio (OR) of self-collected saliva was 196.2022 (95% confidence interval [CI]: 117.8833-326.5546). The area under the summary receiver operating characteristic curve was 0.955. For detecting COVID-19, self-collected saliva had a moderate sensitivity of 0.8476 [0.8045-0.8826] and positive predictive value of 0.9404 [0.9122-0.9599] but high specificity of 0.9817 [0.9707-0.9887] and negative predictive value of 0.9467 [0.9130-0.9678]. In a subgroup analysis, the diagnostic accuracy of self-collected saliva tended to be higher for symptomatic (vs. asymptomatic) examinees.
CONCLUSION
Although naso/oropharyngeal swab tests are the most accurate and important diagnostic tools, the saliva-based testing method can be used as a suitable alternative test, with the advantages of increased patient convenience, efficient testing, and the need for fewer medical staff and resources. In particular, simple collecting method such as drooling or spitting without coughing would be effective in evaluating the symptomatic patients.PROSPERO no.: CRD42021279287.
Topics: COVID-19; Humans; Nasopharynx; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2; Saliva; Sensitivity and Specificity; Specimen Handling
PubMed: 35022280
DOI: 10.15537/smj.2022.43.1.20210743 -
Medicine Apr 2021The aim of this study is to provide the methods used to evaluate the effectiveness and safety of acupuncture therapy for treating drooling in children with cerebral... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The aim of this study is to provide the methods used to evaluate the effectiveness and safety of acupuncture therapy for treating drooling in children with cerebral palsy.
METHODS AND ANALYSIS
A comprehensive search of Pubmed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, 4 Chinese databases (China National Knowledge Infrastructure, Chinese Biomedical Literatures database, Wan-Fang Database and Chinese Science and Technology Periodicals will be conducted to identify randomized controlled trials of acupuncture for treating children with cerebral palsy salivation with no restriction on time or language. The primary outcome of this systematic review will be the effective rate. The risk of bias will be implemented according to Cochrane Handbook for Systematic Reviews of Interventions. We will conduct the meta-analysis to synthesize the evidence for each outcome, if possible. The heterogeneity will be evaluated statistically using the χ2 test and the I2 statistic. The random-effect model will be used to provide more conservative results, if significant heterogeneity is identified (I2 > 50% or P < .10).
ETHICS/DISSEMINATION
Our findings will be disseminated in a peer-reviewed journal and at conference meetings. It is not necessary for formal ethical approval as no primary data are collected.
TRIAL REGISTRATION NUMBER
INPLASY2020110024.
Topics: Acupuncture Therapy; Adolescent; Bias; Cerebral Palsy; Child; Child, Preschool; China; Data Management; Female; Humans; Male; Medicine, Chinese Traditional; Prevalence; Randomized Controlled Trials as Topic; Safety; Sialorrhea; Treatment Outcome
PubMed: 33832131
DOI: 10.1097/MD.0000000000025393 -
Revista Da Associacao Medica Brasileira... 2024
Topics: Humans; Sialorrhea; Child
PubMed: 38655996
DOI: 10.1590/1806-9282.20230971 -
Toxins Mar 2021Parkinson's disease is the most common age-related motoric neurodegenerative disease. In addition to the cardinal motor symptoms of tremor, rigidity, bradykinesia, and...
Parkinson's disease is the most common age-related motoric neurodegenerative disease. In addition to the cardinal motor symptoms of tremor, rigidity, bradykinesia, and postural instability, there are numerous non-motor symptoms as well. Among the non-motor symptoms, autonomic nervous system dysfunction is common. Autonomic symptoms associated with Parkinson's disease include sialorrhea, hyperhidrosis, gastrointestinal dysfunction, and urinary dysfunction. Botulinum neurotoxin has been shown to potentially improve these autonomic symptoms. In this review, the varied uses of botulinum neurotoxin for autonomic dysfunction in Parkinson's disease are discussed. This review also includes discussion of some additional indications for the use of botulinum neurotoxin in Parkinson's disease, including pain.
Topics: Acetylcholine Release Inhibitors; Autonomic Nervous System; Autonomic Nervous System Diseases; Botulinum Toxins; Humans; Parkinson Disease; Treatment Outcome
PubMed: 33808714
DOI: 10.3390/toxins13030226 -
Oral Surgery, Oral Medicine, Oral... Sep 2019The aim of this systematic literature review was to focus on the use of diffusion-weighted magnetic resonance imaging (DWI) in the evaluation of salivary gland diseases.
OBJECTIVES
The aim of this systematic literature review was to focus on the use of diffusion-weighted magnetic resonance imaging (DWI) in the evaluation of salivary gland diseases.
STUDY DESIGN
Databases were searched, and original research manuscripts up to 2018 were identified by using the keywords "diffusion" combined with "salivary gland," "salivary gland neoplasm," "sialadenitis," "parotid gland," "submandibular gland," "sublingual gland," "minor salivary gland," "salivary gland fistula," "salivary gland calculi," "salivary ducts," "xerostomia," and "sialorrhea." Only English language manuscripts and studies pertaining to DWI were selected.
RESULTS
In all, 66 investigations regarding various salivary gland diseases, such as neoplasms, postirradiation changes, and inflammatory and autoimmune diseases, were included. Most study objectives involved the use of the apparent diffusion coefficient (ADC) in differentiating between benign lesions and malignant neoplasms. Histologic features of evaluated samples were heterogeneous.
CONCLUSIONS
DWI may improve the differential diagnosis of salivary gland diseases, particularly in distinguishing between benign and malignant neoplasms. A unique ADC cutoff value could not be established because of the heterogeneity of the methods applied for ADC assessment and the heterogeneity of the diseases. DWI and the ADC are valuable tools in the diagnosis of salivary gland disease.
Topics: Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Humans; Magnetic Resonance Imaging; Parotid Gland; Salivary Gland Diseases; Xerostomia
PubMed: 31029591
DOI: 10.1016/j.oooo.2019.02.020 -
Journal of Clinical Neuromuscular... Jun 2020Half of patients with amyotrophic lateral sclerosis experience sialorrhea due to facial weakness. Although anticholinergic medications are first-line therapy, they often...
OBJECTIVES
Half of patients with amyotrophic lateral sclerosis experience sialorrhea due to facial weakness. Although anticholinergic medications are first-line therapy, they often lead to unacceptable side effects. Radiation therapy and botulinum toxin may be considered when medical management fails. In this systematic review, we investigated the effectiveness of these interventions.
METHODS
Eligible studies were retrieved from PubMed and Scopus databases up to March 2017 along with hand-searching of references from primary articles.
RESULTS
Fourteen studies (N = 138) examined the benefits of botulinum toxin. Studies varied in salivary glands treated, dosages used, and the use of botulinum toxin subtype A or B. A majority of studies showed benefit after treatment. Although most studies reported only mild adverse effects, 2 case studies revealed severe complications including recurrent TMJ dislocations and rapid deterioration in bulbar function. Ten studies (N = 171) examined the benefits of radiation. Most studies reported improvement with only mild adverse events reported.
CONCLUSIONS
Both radiation and botulinum toxin are effective treatments for sialorrhea in patients with amyotrophic lateral sclerosis and should be considered when medical management fails. Radiation may offer longer duration of symptom improvement with fewer complications.
Topics: Aged; Amyotrophic Lateral Sclerosis; Botulinum Toxins; Female; Humans; Male; Middle Aged; Neuromuscular Agents; Sialorrhea; Treatment Outcome
PubMed: 32453096
DOI: 10.1097/CND.0000000000000273 -
Revista de Neurologia Nov 2019Sialorrhoea is an important sign in children with central nervous system conditions that seriously affects health and quality of life. Kinesiotaping is presented as a...
INTRODUCTION
Sialorrhoea is an important sign in children with central nervous system conditions that seriously affects health and quality of life. Kinesiotaping is presented as a non-invasive alternative that is useful in controlling the swallowing of saliva.
AIM
To examine the efficacy of kinesiotaping as a therapeutic resource in the control of sialorrhoea.
PATIENTS AND METHODS
A bibliographic search was carried out in the databases Scopus, PubMed, Web of Science, Cochrane Library, Science Direct and Google Scholar, using the terms «bandages», «tape», «kinesiotaping», «sialorrea», «deglutition», «drooling» and «swallowing difficulty», and the methodological quality was evaluated with Form-Quantitative Studies and the Oxford scale.
RESULTS
Ten studies were selected for review: six of which applied kinesiotaping in the suprahyoid area and four in the area of the orbicularis muscle of the lips. All studies show significant differences in the use of different treatment techniques, but without any significant differences between kinesiotaping and other techniques.
CONCLUSIONS
Studies of high methodological quality are scarce; however, significant improvements in outcomes and no adverse effects are reported, which may have a positive influence on the clinical features and on day-to-day therapy.
Topics: Adolescent; Athletic Tape; Central Nervous System Diseases; Child; Child, Preschool; Female; Humans; Male; Sialorrhea
PubMed: 31657447
DOI: 10.33588/rn.6909.2019052 -
Clinical Case Reports Nov 2019Clozapine is considered the golden standard in the treatment of therapy-resistant schizophrenia; however, it associated with bothersome side effects such as sialorrhea....
Clozapine is considered the golden standard in the treatment of therapy-resistant schizophrenia; however, it associated with bothersome side effects such as sialorrhea. Current evidence suggests that the sublingual use of atropine seems to be safe and effective and could be considered as a first-line treatment of clozapine-induced sialorrhea.
PubMed: 31788260
DOI: 10.1002/ccr3.2431