[Submandibular gland resection for the management of sialorrhea in paediatric patients with cerebral palsy and unresponsive to type A botullinum toxin. Pilot study]. / Resección de glándulas submandibulares para manejo de sialorrea en pacientes pediátricos con parálisis cerebral y poca respuesta a la toxina botulínica tipo A. Estudio piloto.
Cir Cir
; 84(6): 459-468, 2016.
Article
em Es
| MEDLINE
| ID: mdl-27221328
BACKGROUND: Sialorrhoea has a prevalence of between 10% and 58% in patients with cerebral palsy. Amongst the invasive treatments, botulinum toxin-A injections in submandibular and parotid glands and various surgical techniques are worth mentioning. There are no studies in Mexico on the usefulness of surgery to manage sialorrhoea. OBJECTIVE: To evaluate the usefulness of submandibular gland resection in improving sialorrhoea in patients with cerebral palsy and with a poor response to botulinum toxin. MATERIAL AND METHODS: Experimental, clinical, self-controlled, prospective trial was conducted to evaluate the grade of sialorrhoea before surgery, and 8, 16 and 24 weeks after. Statistical analysis was performed using a non-parametric repetitive measure assessment, considering a p < 0.05 as significant. Complications and changes in salivary composition were evaluated. RESULTS: Surgery was performed on 3 patients with severe sialorrhoea, and 2 with profuse sialorrhoea, with mean age of 10.8 years. The frequency and severity of sialorrhoea improved in the 5 patients, with mean of 76.7 and 87.5% improvement, respectively. The best results were seen after 6 months of surgery, with a statistically significant difference between the preoperative stage and 6 months after the procedure (p = 0.0039, 95% CI). No significant differences were observed in complications, increase in periodontal disease or cavities, or salivary composition. CONCLUSIONS: Submandibular gland resection is an effective technique for sialorrhoea control in paediatric patients with cerebral palsy, with a reduction in salivary flow greater than 80%. It has a low chance of producing complications compared to other techniques. It led to an obvious decrease in sialorrhoea without the need to involve other salivary glands in the procedure.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sialorreia
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Glândula Submandibular
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Toxinas Botulínicas Tipo A
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Observational_studies
Limite:
Adolescent
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Child
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Humans
Idioma:
Es
Revista:
Cir Cir
Ano de publicação:
2016
Tipo de documento:
Article
País de publicação:
México