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Abstract
Sialorrhoea or drooling can be a problematic symptom seen commonly in children with neurological conditions associated with bulbar dysfunction, which may be due to over production of saliva or reduced swallowing of saliva, and may be classified as anterior or posterior drooling.
There are many treatment options from conservative management for anterior drooling such as oral/sensory motor therapy and behavioural intervention, to pharmacological and more invasive surgical intervention or botulinum toxin (Botox) injections for posterior drooling. There has been no consensus on which treatment is most effective, so many may be trialled to achieve a good response and better saliva control.
The use of salivary gland targeted radiotherapy to manage secretions in children is rarely documented, but widely used in progressive neurological conditions in adults, such as Parkinson’s disease and motor neurone disease.
In this case report, we review the use of targeted radiotherapy for the management of drooling in a 15 year old boy, and the effectiveness of this method of treatment.
Two years following on from treatment, the patient’s drooling remains well controlled with one medication, and his quality of life has improved.
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Copyright (c) 2024 Alison Cashell
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References
- – Reid, S.M., McCutcheon, J., Reddihough, D.S. and Johnson, H., 2012. Prevalence and predictors of drooling in 7‐to 14‐year‐old children with cerebral palsy: a population study. Developmental Medicine & Child Neurology, 54(11), pp.1032-1036.
- – Reid, S.M., Johnson, H.M. and Reddihough, D.S., 2010. The Drooling Impact Scale: a measure of the impact of drooling in children with developmental disabilities. Developmental Medicine & Child Neurology, 52(2), pp.e23-e28.
- – McGeachan AJ, and McDermott CJ., 2017. Management of oral secretions in neurological disease. Pract Neurol, 17(2):96-103. doi: 10.1136/practneurol-2016-001515. Epub 2017 Feb 10. PMID: 28188210.
- - Pellegrini, A., Lunetta, C., Ferrarese, C. and Tremolizzo, L., 2015. Sialorrhoea: how to manage a frequent complication of motor neuron disease. EMJ Neurology, 3, p.107.
- – Hawkey, N.M., Zaorsky, N.G. and Galloway, T.J., 2016. The role of radiation therapy in the management of sialorrhea: a systematic review. The Laryngoscope, 126(1), pp.80-85.
- – Palmer, J., Tsang, D., Tinkle, C., olch, A., Kremer, L., Ronckers, C., Gibbs, I., and Constine L., 2021. Late effects of radiation therapy in pediatric patients and survivorship. Pediatric Blood and Cancer, 68 (Suppl. 2)
- – Shehee, L., O'Rourke, A. and Garand, K.L., 2020. The Role of Radiation Therapy and Botulinum Toxin Injections in the Management of Sialorrhea in Patients With Amyotrophic Lateral Sclerosis: A Systematic Review. Journal of Clinical Neuromuscular Disease, 21(4), pp.205-221.
- – Lawrence, R. and Bateman, N., 2018. Surgical management of the drooling child. Current otorhinolaryngology reports, 6(1), pp.99-106.
- – Khajuria, S., Ng, K.F. and Jefferson, R.J., 2020. What is the effectiveness and safety of different interventions in the management of drooling in children with cerebral palsy? Archives of Disease in Childhood, 105(9), pp.906-910.
References
– Reid, S.M., McCutcheon, J., Reddihough, D.S. and Johnson, H., 2012. Prevalence and predictors of drooling in 7‐to 14‐year‐old children with cerebral palsy: a population study. Developmental Medicine & Child Neurology, 54(11), pp.1032-1036.
– Reid, S.M., Johnson, H.M. and Reddihough, D.S., 2010. The Drooling Impact Scale: a measure of the impact of drooling in children with developmental disabilities. Developmental Medicine & Child Neurology, 52(2), pp.e23-e28.
– McGeachan AJ, and McDermott CJ., 2017. Management of oral secretions in neurological disease. Pract Neurol, 17(2):96-103. doi: 10.1136/practneurol-2016-001515. Epub 2017 Feb 10. PMID: 28188210.
- Pellegrini, A., Lunetta, C., Ferrarese, C. and Tremolizzo, L., 2015. Sialorrhoea: how to manage a frequent complication of motor neuron disease. EMJ Neurology, 3, p.107.
– Hawkey, N.M., Zaorsky, N.G. and Galloway, T.J., 2016. The role of radiation therapy in the management of sialorrhea: a systematic review. The Laryngoscope, 126(1), pp.80-85.
– Palmer, J., Tsang, D., Tinkle, C., olch, A., Kremer, L., Ronckers, C., Gibbs, I., and Constine L., 2021. Late effects of radiation therapy in pediatric patients and survivorship. Pediatric Blood and Cancer, 68 (Suppl. 2)
– Shehee, L., O'Rourke, A. and Garand, K.L., 2020. The Role of Radiation Therapy and Botulinum Toxin Injections in the Management of Sialorrhea in Patients With Amyotrophic Lateral Sclerosis: A Systematic Review. Journal of Clinical Neuromuscular Disease, 21(4), pp.205-221.
– Lawrence, R. and Bateman, N., 2018. Surgical management of the drooling child. Current otorhinolaryngology reports, 6(1), pp.99-106.
– Khajuria, S., Ng, K.F. and Jefferson, R.J., 2020. What is the effectiveness and safety of different interventions in the management of drooling in children with cerebral palsy? Archives of Disease in Childhood, 105(9), pp.906-910.