Clinical and Laryngotracheoscopic Evaluation of Children with Cerebral Palsy Using Intraparotid Injections of Botulinum Toxin Type A for Drooling Control

Abstract

Introduction: Medical literature shows consistent data on the use of botulinum toxin for the treatment of drooling, especially in patients with neurological disorder. However, any trial evaluated the reduction of sialorrhea through laryngotracheoscopy. Objective: To evaluate the reduction of salivation and aspiration in children with cerebral palsy submitted to intraparotid injection of botulinum toxin. Methods: A prospective cohort study including 31 pediatric patients with cerebral palsy who complained of sialorrhea and were submitted to an intraparotid injection of botulinum toxin type A. It was analysed the reduction of the number of bibs and the amount of saliva in the larynx and trachea through a laryngotracheoscopic examination. Results: There was a reduction in the number of bibs from 7.35 to 4 after application of BoNT/A, with p-value < 0.001. The age of the patients did not influence on the number of bibs. 71% of the patients reduced the amount of saliva in laryngotracheoscopic examination. The number of normal exams increased from 3.2% to 38.7% and aspiration fell from 38.7% to 12.9%. Conclusion: Application of botulinum toxin type A is a good method for temporary control of salivation in children with neurological disorders.