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Surgery versus botulinum neurotoxin A to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial

AIM: To compare the effect of bilateral submandibular duct ligation and botulinum neurotoxin A (BoNT‐A) on drooling severity and its impact on daily life and care in children and adolescents with moderate‐to‐severe drooling. METHOD: This was a randomized, interventional, controlled trial in which 53...

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Autores principales: Bekkers, Stijn, Pruijn, Ineke M J, van der Burg, Jan J W, van Hulst, Karen, Kok, Saskia E, Delsing, Corinne P, Scheffer, Arthur R T, van den Hoogen, Frank J A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597158/
https://www.ncbi.nlm.nih.gov/pubmed/33997959
http://dx.doi.org/10.1111/dmcn.14924
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author Bekkers, Stijn
Pruijn, Ineke M J
van der Burg, Jan J W
van Hulst, Karen
Kok, Saskia E
Delsing, Corinne P
Scheffer, Arthur R T
van den Hoogen, Frank J A
author_facet Bekkers, Stijn
Pruijn, Ineke M J
van der Burg, Jan J W
van Hulst, Karen
Kok, Saskia E
Delsing, Corinne P
Scheffer, Arthur R T
van den Hoogen, Frank J A
author_sort Bekkers, Stijn
collection PubMed
description AIM: To compare the effect of bilateral submandibular duct ligation and botulinum neurotoxin A (BoNT‐A) on drooling severity and its impact on daily life and care in children and adolescents with moderate‐to‐severe drooling. METHOD: This was a randomized, interventional, controlled trial in which 53 children and adolescents (31 males, 22 females, mean age 11y, range 8–22y, SD 2y 10mo) with cerebral palsy (58.5%) or other non‐progressive developmental disorders (41.5%) were randomized to BoNT‐A (n=26) or bilateral submandibular duct ligation (n=27). A parent questionnaire on the severity of drooling in specific positions and daily activities and the impact of drooling on daily life and care was filled out at baseline and 8 and 32 weeks posttreatment. RESULTS: Both BoNT‐A and bilateral submandibular duct ligation had a positive effect on daily care, damage to electronic equipment and/or furniture, social interactions, and self‐esteem. However, bilateral submandibular duct ligation had a significant greater and longer‐lasting short‐ (8wks) and medium‐term (32wks) effect on daily care, reducing damage to electronic devices, and improving social interactions and satisfaction with life in general. INTERPRETATION: This randomized controlled trial confirms reduced drooling by both BoNT‐A and bilateral submandibular duct ligation, but provides new evidence on improved well‐being through a reduction in drooling. Even though there is a greater risk of complications and morbidity after bilateral submandibular duct ligation, compared to BoNT‐A there was a significantly greater and longer‐lasting positive effect on most outcomes. WHAT THIS PAPER ADDS: Bilateral botulinum neurotoxin A (BoNT‐A) and submandibular duct ligation had a positive effect on the well‐being of individuals with moderate‐to‐severe drooling. Bilateral submandibular duct ligation had a greater effect on the impact of drooling during daily care than BoNT‐A. Bilateral submandibular duct ligation reduced damage to electronic devices and improved social interactions and satisfaction with life.
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spelling pubmed-85971582021-11-22 Surgery versus botulinum neurotoxin A to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial Bekkers, Stijn Pruijn, Ineke M J van der Burg, Jan J W van Hulst, Karen Kok, Saskia E Delsing, Corinne P Scheffer, Arthur R T van den Hoogen, Frank J A Dev Med Child Neurol Original Articles AIM: To compare the effect of bilateral submandibular duct ligation and botulinum neurotoxin A (BoNT‐A) on drooling severity and its impact on daily life and care in children and adolescents with moderate‐to‐severe drooling. METHOD: This was a randomized, interventional, controlled trial in which 53 children and adolescents (31 males, 22 females, mean age 11y, range 8–22y, SD 2y 10mo) with cerebral palsy (58.5%) or other non‐progressive developmental disorders (41.5%) were randomized to BoNT‐A (n=26) or bilateral submandibular duct ligation (n=27). A parent questionnaire on the severity of drooling in specific positions and daily activities and the impact of drooling on daily life and care was filled out at baseline and 8 and 32 weeks posttreatment. RESULTS: Both BoNT‐A and bilateral submandibular duct ligation had a positive effect on daily care, damage to electronic equipment and/or furniture, social interactions, and self‐esteem. However, bilateral submandibular duct ligation had a significant greater and longer‐lasting short‐ (8wks) and medium‐term (32wks) effect on daily care, reducing damage to electronic devices, and improving social interactions and satisfaction with life in general. INTERPRETATION: This randomized controlled trial confirms reduced drooling by both BoNT‐A and bilateral submandibular duct ligation, but provides new evidence on improved well‐being through a reduction in drooling. Even though there is a greater risk of complications and morbidity after bilateral submandibular duct ligation, compared to BoNT‐A there was a significantly greater and longer‐lasting positive effect on most outcomes. WHAT THIS PAPER ADDS: Bilateral botulinum neurotoxin A (BoNT‐A) and submandibular duct ligation had a positive effect on the well‐being of individuals with moderate‐to‐severe drooling. Bilateral submandibular duct ligation had a greater effect on the impact of drooling during daily care than BoNT‐A. Bilateral submandibular duct ligation reduced damage to electronic devices and improved social interactions and satisfaction with life. John Wiley and Sons Inc. 2021-05-16 2021-11 /pmc/articles/PMC8597158/ /pubmed/33997959 http://dx.doi.org/10.1111/dmcn.14924 Text en © 2021 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Bekkers, Stijn
Pruijn, Ineke M J
van der Burg, Jan J W
van Hulst, Karen
Kok, Saskia E
Delsing, Corinne P
Scheffer, Arthur R T
van den Hoogen, Frank J A
Surgery versus botulinum neurotoxin A to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial
title Surgery versus botulinum neurotoxin A to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial
title_full Surgery versus botulinum neurotoxin A to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial
title_fullStr Surgery versus botulinum neurotoxin A to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial
title_full_unstemmed Surgery versus botulinum neurotoxin A to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial
title_short Surgery versus botulinum neurotoxin A to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial
title_sort surgery versus botulinum neurotoxin a to reduce drooling and improve daily life for children with neurodevelopmental disabilities: a randomized controlled trial
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597158/
https://www.ncbi.nlm.nih.gov/pubmed/33997959
http://dx.doi.org/10.1111/dmcn.14924
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