Botox to reduce drooling in South African neurologically impaired children : a retrospective study.
Date
2009-03-20T09:22:10Z
Authors
Hay, Nicola Michelle
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Abstract
Drooling management in the neurologically impaired pediatric population is a
challenge. Surgery is considered an invasive procedure, while behaviour
modification techniques, correction of situational factors and oral-motor therapy
do not always produce sustained improvement. In recent years Botox® has been
investigated. This study comprised analyses of clinical data obtained from a
Drooling Treatment Project (DTP) conducted at a school for special needs
children in South Africa. The aims of the DTP were to establish the response of
drooling in a number of different contexts, following bilateral submandibular
salivary gland injections of Botox®. Two groups of children were involved, 7
children with cerebral palsy and 2 children with operculum syndrome. Drooling
was assessed in 5 different situations and at different time points pre- and post
Botox® injection up to 6 months. Parents’/primary caregivers’ perceptions of
drooling and treatment with Botox® were also measured using an interview form
and a quality of life questionnaire. Results showed that drooling was reduced in
all situations, with significant reductions in the general and communicating
situations. These results indicate that the context in which drooling occurs is an
important factor and suggest the value of considering the situational context when
making drooling judgements. Further, there was a difference in the pattern of
response between the 2 groups. This finding has implications, not only for future
research, but also for models of explanation of the effects of Botox®. Most
parents/primary caregivers felt their children’s lives and their own had improved
following the Botox® injection and would repeat the treatment. Clinical and
research implications are discussed, with reference to the South African context.
Description
Keywords
Cerebral palsy, Operculum syndrome, Drooling, Salivary glands, Botulinum toxin type A, Quality of life, Severity and frequency rating scales, Botox