Ultrasound-guided injection of botulinum toxin A into the submandibular gland in children and young adults with sialorrhoea

Published:September 03, 2012DOI:


      Hypersalivation is a common and distressing complaint in children with neuromuscular disorders such as cerebral palsy. Complications associated with severe drooling include daily changes of clothing, perioral dermatitis, dental problems, dehydration, and aspiration pneumonia, which potentially have a detrimental effect on the quality of life of the patient and carer. In this paper we update our previous work to show the potential benefits of ultrasound-guided injection of botulinum toxin A (BTX-A) into the submandibular gland and report on new patients and follow-up data on the existing group.


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        • Van De Heyning P.H.
        • Marquet J.F.
        • Creten W.L.
        Drooling in children with cerebral palsy.
        Acta Oto-Rhino-Laryngologica Belgica. 1980; 34: 691-705
        • Ekedahl C.
        • Hallén O.
        Quantitative measurement of drooling.
        Acta Oto-Laryngologica. 1973; 75: 464-469
        • Sriskandan N.
        • Moody A.
        • Howlett D.C.
        Ultrasound-guided submandibular gland injection of botulinum toxin for hypersalivation in cerebral palsy.
        British Journal of Oral and Maxillofacial Surgery. 2010; 48: 58-60
        • Scheffer A.R.
        • Erasmus C.
        • Van Hulst K.
        • Van Limbeek J.
        • Rotteveel J.J.
        • Jongerius P.H.
        • et al.
        Botulinum toxin versus submandibular duct relocation for severe drooling.
        Developmental Medicine and Child Neurology. 2010; 52: 1038-1042
        • Jongerius P.H.
        • van den Hoogen F.J.
        • van Limbeek J.
        • Garreëls F.J.
        • van Hulst K.
        • Rotteveel J.J.
        Effect of botulinum toxin in the treatment of drooling: a controlled clinical trial.
        Pediatrics. 2004; 114: 620-627
        • Suskind D.L.
        • Tilton A.
        Clinical study of botulinum-A toxin in the treatment of sialorrhea in children with cerebral palsy.
        Laryngoscope. 2002; 112: 73-81