Treatment of sialorrhea with botulinum toxin injections in pediatric patients less than three years of age.
Int J Pediatr Otorhinolaryngol 2022;
158:111185. [PMID:
35594794 DOI:
10.1016/j.ijporl.2022.111185]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 03/30/2022] [Accepted: 05/11/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE
To determine the patient demographics and the efficacy and safety profile of botulinum toxin (BTX) injections for sialorrhea control in patients under the age of three.
METHODS
This is a retrospective chart review study. Patients under three years of age who received BTX injections for sialorrhea management from 2010 to 2021 were assessed. Patient demographics, comorbidities, medical and surgical histories, indications, BTX injection details, and post injection complications were documented.
RESULTS
Forty-nine patients met inclusion criteria. The most common patient under three years of age with sialorrhea to receive BTX injections were white (51.0%) male (51.0%) with congenital (73.5%) and/or neurologic (53.1%) comorbidities. Thirty-six (73.5%) patients were from medically underserved areas/populations. Our patients on average received 1.7 injections, with 44.9% requiring multiple BTX injections. Bilateral parotid and bilateral submandibular glands (four-gland) BTX injections were associated with significant decrease in admissions for pneumonia and cessation of anticholinergics usage (both P < 0.05). Post BTX injections, 15 (30.6%) patients required additional surgeries for sialorrhea control. No adverse outcomes due to BTX injections were reported.
CONCLUSIONS
Pediatric sialorrhea was commonly associated with congenital and/or neurologic comorbidities and disproportionately impacted medically underserved black patients. BTX injections offered multifaceted benefits for controlling sialorrhea in patients under the age of three. Four-gland BTX injections led to reduction of unnecessary hospitalization, usage of anticholinergics, and additional surgeries for sialorrhea management.
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