The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform
Frank J. A. Van Den Hoogen - One of the best experts on this subject based on the ideXlab platform.
-
Submandibular Duct ligation after botulinum neurotoxin A treatment of drooling in children with cerebral palsy
Developmental medicine and child neurology, 2020Co-Authors: Stijn Bekkers, Ineke M J Pruijn, Karen Van Hulst, Corinne P. Delsing, Corrie E. Erasmus, Arthur R. T. Scheffer, Frank J. A. Van Den HoogenAbstract:Aim To assess: (1) the effect on drooling of bilateral Submandibular Duct ligation as surgical therapy after the administration of Submandibular botulinum neurotoxin A (BoNT-A) for excessive drooling and (2) the predictive value of treatment success with BoNT-A on treatment success after bilateral Submandibular Duct ligation. Method This was a within-participant retrospective observational study in which 29 children with severe drooling (15 males, 14 females) received BoNT-A treatment at a mean age of 9 years 6 months (SD 2y 5mo), followed by bilateral Submandibular Duct ligation at a mean age of 10 years 11 months (SD 2y 4mo). Fifteen children were diagnosed with cerebral palsy (CP), with 12 children classified in Gross Motor Function Classification System levels IV and V. The 14 children without CP had non-progressive developmental disorders. The primary drooling severity outcomes were the Visual Analogue Scale (VAS; subjective assessment) and drooling quotient (objective assessment). Measurements were taken before each intervention and again at 8 and 32 weeks. Results The VAS was significantly lower after bilateral Submandibular Duct ligation at follow-up compared to BoNT-A treatment (mean difference -33, p≤0.001; 95% confidence interval [CI]=-43.3 to -22.9). The mean drooling quotient did not significantly differ between BoNT-A treatment and bilateral Submandibular Duct ligation at follow-up (3.3, p=0.457; 95% CI=-4.35 to 9.62) or between 8 and 32 weeks (4.7, p=0.188; 95% CI=-2.31 to 11.65). Interpretation BoNT-A treatment and bilateral Submandibular Duct ligation are both effective treatment modalities for drooling. At 32-week follow-up, subjective drooling severity after bilateral Submandibular Duct ligation was significantly lower compared to previous BoNT-A injections in participants. However, treatment success with BoNT-A is no precursor to achieving success with bilateral Submandibular Duct ligation. What this paper adds Bilateral Submandibular Duct ligation is an effective therapy for drooling after treatment with botulinum neurotoxin A (BoNT-A). Treatment success with BoNT-A is not a predictor of successful therapy with bilateral Submandibular Duct ligation.
-
Submandibular gland botulinum neurotoxin A injection for predicting the outcome of Submandibular Duct relocation in drooling: a retrospective cohort study.
Developmental medicine and child neurology, 2019Co-Authors: Saskia E. Kok, Karen Van Hulst, Corrie E. Erasmus, Hans F J P Van Valenberg, Peter H. Jongerius, Frank J. A. Van Den HoogenAbstract:Aim This study evaluated whether the effect of Submandibular gland botulinum neurotoxin A (BoNT-A) injection can predict the outcome of Submandibular Duct relocation with sublingual gland excision (SMDR) in children with drooling. Furthermore, we compared the effectiveness of both procedures. Method A retrospective cohort study was performed in 42 children and adolescents (25 males, 17 females; mean [SD] age at BoNT-A injection 11y [4], range 4-20y; mean [SD] age at SMDR 15y [4], range 7-23y) with cerebral palsy or another non-progressive developmental disability who had undergone both BoNT-A injection and SMDR for drooling. Main outcomes were the drooling quotient and the visual analogue scale (VAS) on drooling severity at 8 weeks and 32 weeks follow-up. Results Failure or success of previous BoNT-A injections had no influence on success of consecutive SMDR. Relative change in main outcomes showed no significant relation between BoNT-A injection and SMDR for any follow-up measurement. After 8 weeks, SMDR was more successful than BoNT-A injection in diminishing VAS (VAS 80.0% vs 54.3%; drooling quotient 56.2% vs 51.0%). After 32 weeks, both drooling quotient (64.3% vs 29.5%) and VAS (75.7% vs 37.1%) showed significantly higher proportions of success for SMDR. Interpretation The effect of Submandibular BoNT-A injection does not predict subsequent SMDR success in drooling. Furthermore, SMDR has a larger and longer-lasting positive effect on drooling than BoNT-A injections. What this paper adds Submandibular botulinum neurotoxin A (BoNT-A) injection effect does not predict Submandibular Duct relocation with sublingual gland excision outcome. Submandibular Duct relocation is more effective and more permanent than BoNT-A injection.
-
Effectiveness of Submandibular Duct relocation in 91 children with excessive drooling: A prospective cohort study
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2018Co-Authors: Saskia E. Kok, Karen Van Hulst, Corrie E. Erasmus, Arthur R. T. Scheffer, Maroeska M. Rovers, Frank J. A. Van Den HoogenAbstract:Objective To evaluate the effectiveness of Submandibular Duct relocation (SMDR) in drooling children with neurological disorders. Design Prospective cohort study. Setting Academic Outpatient Saliva Control Clinic. Participants Ninety-one children suffering from moderate to severe drooling. Main outcome measures Direct observational drooling quotient (DQ; 0-100) and caretaker Visual Analogue Scale (VAS; 0-100). Secondary outcome measures were drooling severity (DS) and frequency rating scales. Results The DQ at baseline, 8 and 32 weeks postoperatively was 26.4, 12.3 and 10.8, respectively. VAS score decreased from 80.1 at baseline to 28.3 and 37.0 at 8 and 32 weeks after surgery. Median DS at baseline, 8 and 32 weeks was 5, 3 and 4, whereas the drooling frequency median scores were 4, 2 and 2, respectively. Five children required prolonged intubation due to transient floor of the mouth swelling, two of whom developed a ventilator-associated pneumonia. Another child developed atelectasis with postoperative pneumonia. Two more children needed tube feeding because of postoperative eating difficulties for 3 days or suprapubic catheterisation for urinary retention. Children aged 12 years or older (OR = 3.41; P = 0.03) and those with adequate stability and position of the head (OR = 2.84; P = 0.09) appeared to benefit most from treatment. Conclusions Submandibular Duct relocation combined with excision of the sublingual glands appears to be relatively safe and effective in diminishing visible drooling in children with neurological disorders, particularly in children aged 12 years and older and those without a forward head posture.
-
The impact of Submandibular Duct relocation on drooling and the well-being of children with neurodevelopmental disabilities
International journal of pediatric otorhinolaryngology, 2016Co-Authors: Saskia E. Kok, Karen Van Hulst, Corrie E. Erasmus, Jan J. W. Van Der Burg, Frank J. A. Van Den HoogenAbstract:Abstract Objective The aim of this study was to evaluate the impact of a reDuction in drooling after bilateral Submandibular Duct relocation (SMDR) with sublingual gland excision on daily life and care, as well as social and emotional consequences in children and adolescents with neurodevelopmental disabilities. Methods This prospective cohort study included 72 children and adolescents (46 males, 26 females) with moderate to severe drooling, and their caregivers. Mean age at the time of surgery was 15 years 2 months (SD 4y 3mo). Fifty-two children were diagnosed with cerebral palsy and 20 had other non-progressive developmental disabilities. A caregiver questionnaire to document the impact of drooling on daily care and economic consequences, social interaction and emotional development and self-esteem was administered before, and 8 and 32 weeks after surgery. Results Following bilateral SMDR the mean Visual Analogue Scale (VAS, 0–100) scores demonstrated a significant (p Conclusion Bilateral SMDR with sublingual gland excision provides a significant positive reDuction in daily care of children suffering from drooling. Caregivers also report positive changes in their child's social interaction and sense of self-esteem.
-
botulinum toxin versus Submandibular Duct relocation for severe drooling
Developmental Medicine & Child Neurology, 2010Co-Authors: Arthur R. T. Scheffer, Karen Van Hulst, Corrie E. Erasmus, Peter H. Jongerius, Jacques Van Limbeek, Jan J. Rotteveel, Frank J. A. Van Den HoogenAbstract:Aim Botulinum neurotoxin type A (BoNT-A) has been described as an effective intervention for drooling and is being increasingly adopted. However, its effectiveness compared with established treatments is still unknown. We undertook a within-participants observational study to examine this. Method An historic cohort was formed of 19 children and young adults (10 males, nine females) with severe drooling who underwent BoNT-A injections followed by surgical re-routing of the Submandibular Duct at least 6 months later. Mean age at time of admission was 11 years 5 months (range 5–17y) and mean age at the time of surgery was 14 years (range 6–23y). Fifteen children were diagnosed with bilateral cerebral palsy (CP), three with unilateral CP, and one with non-progressive developmental delay. Gross Motor Function Classification System levels were the following: level I, n=1; level II, n=2; level III, n=7; level IV, n=6; and level V, n=3). The primary outcome was the drooling quotient, which was assessed before each intervention and 8 and 32 weeks thereafter. A multivariate analysis of variance of repeated measures was performed, with the measurement points as the within-participant variables. Results The drooling quotient was reduced to a greater extent after surgery than after BoNT-A administration (p=0.001). Compared with a baseline value of 28, the mean drooling quotient 8 weeks after surgery was 10, and 32 weeks after surgery was 4 (p<0.001). Among the group treated with BoNT-A, the drooling quotient showed a significant reDuction from a baseline value of 30 to 18 after 8 weeks (p=0.02), and a continued but diminished effect after 32 weeks (drooling quotient 22; p=0.05). Interpretation Both interventions are effective, but surgery provides a larger and longer-lasting effect.
Corrie E. Erasmus - One of the best experts on this subject based on the ideXlab platform.
-
Submandibular Duct ligation after botulinum neurotoxin A treatment of drooling in children with cerebral palsy
Developmental medicine and child neurology, 2020Co-Authors: Stijn Bekkers, Ineke M J Pruijn, Karen Van Hulst, Corinne P. Delsing, Corrie E. Erasmus, Arthur R. T. Scheffer, Frank J. A. Van Den HoogenAbstract:Aim To assess: (1) the effect on drooling of bilateral Submandibular Duct ligation as surgical therapy after the administration of Submandibular botulinum neurotoxin A (BoNT-A) for excessive drooling and (2) the predictive value of treatment success with BoNT-A on treatment success after bilateral Submandibular Duct ligation. Method This was a within-participant retrospective observational study in which 29 children with severe drooling (15 males, 14 females) received BoNT-A treatment at a mean age of 9 years 6 months (SD 2y 5mo), followed by bilateral Submandibular Duct ligation at a mean age of 10 years 11 months (SD 2y 4mo). Fifteen children were diagnosed with cerebral palsy (CP), with 12 children classified in Gross Motor Function Classification System levels IV and V. The 14 children without CP had non-progressive developmental disorders. The primary drooling severity outcomes were the Visual Analogue Scale (VAS; subjective assessment) and drooling quotient (objective assessment). Measurements were taken before each intervention and again at 8 and 32 weeks. Results The VAS was significantly lower after bilateral Submandibular Duct ligation at follow-up compared to BoNT-A treatment (mean difference -33, p≤0.001; 95% confidence interval [CI]=-43.3 to -22.9). The mean drooling quotient did not significantly differ between BoNT-A treatment and bilateral Submandibular Duct ligation at follow-up (3.3, p=0.457; 95% CI=-4.35 to 9.62) or between 8 and 32 weeks (4.7, p=0.188; 95% CI=-2.31 to 11.65). Interpretation BoNT-A treatment and bilateral Submandibular Duct ligation are both effective treatment modalities for drooling. At 32-week follow-up, subjective drooling severity after bilateral Submandibular Duct ligation was significantly lower compared to previous BoNT-A injections in participants. However, treatment success with BoNT-A is no precursor to achieving success with bilateral Submandibular Duct ligation. What this paper adds Bilateral Submandibular Duct ligation is an effective therapy for drooling after treatment with botulinum neurotoxin A (BoNT-A). Treatment success with BoNT-A is not a predictor of successful therapy with bilateral Submandibular Duct ligation.
-
unsuccessful Submandibular Duct surgery for anterior drooling surgical failure or parotid gland salivation
International Journal of Pediatric Otorhinolaryngology, 2019Co-Authors: Corinne P. Delsing, Stijn Bekkers, Corrie E. Erasmus, Karen Van Hulst, Frank J A Van Den HoogenAbstract:Abstract Objectives To evaluate if drooling recurrence after surgery of the Submandibular Ducts is due to surgical failure or other variables. Methods Historic cohort with prospective collected data of all patients with severe drooling who underwent unsuccessful Submandibular Duct surgery with subsequent re-intervention between 2003 and 2018. A reference cohort was used for comparison of clinical variables. Results Six males and 4 females were included (cerebral palsy n = 8, neurodevelopmental disorders n = 2). All patients underwent Submandibular gland surgery as a primary intervention (Duct ligation n = 8, Submandibular Duct relocation n = 2) followed by re-intervention (Submandibular gland excision n = 7, parotid Duct ligation n = 3). One patient underwent tertiary surgery (parotid Duct ligation after re-intervention by Submandibular gland excision). Three patients were successful after re-intervention. No difference was found between both re-intervention techniques. There was significantly more severe dental malocclusion (50% vs. 21%, P value = 0.047) and severe speech disorders (80% vs. 42%, P value = 0.042) in the current cohort when compared to the reference cohort. Conclusion Recurrence of drooling surgery is most likely not caused by surgical failure of the primary intervention, because re-intervention (Submandibular gland excision) did not lead to more success. Dysarthria and dental malocclusion might negatively influence treatment outcome.
-
Submandibular gland botulinum neurotoxin A injection for predicting the outcome of Submandibular Duct relocation in drooling: a retrospective cohort study.
Developmental medicine and child neurology, 2019Co-Authors: Saskia E. Kok, Karen Van Hulst, Corrie E. Erasmus, Hans F J P Van Valenberg, Peter H. Jongerius, Frank J. A. Van Den HoogenAbstract:Aim This study evaluated whether the effect of Submandibular gland botulinum neurotoxin A (BoNT-A) injection can predict the outcome of Submandibular Duct relocation with sublingual gland excision (SMDR) in children with drooling. Furthermore, we compared the effectiveness of both procedures. Method A retrospective cohort study was performed in 42 children and adolescents (25 males, 17 females; mean [SD] age at BoNT-A injection 11y [4], range 4-20y; mean [SD] age at SMDR 15y [4], range 7-23y) with cerebral palsy or another non-progressive developmental disability who had undergone both BoNT-A injection and SMDR for drooling. Main outcomes were the drooling quotient and the visual analogue scale (VAS) on drooling severity at 8 weeks and 32 weeks follow-up. Results Failure or success of previous BoNT-A injections had no influence on success of consecutive SMDR. Relative change in main outcomes showed no significant relation between BoNT-A injection and SMDR for any follow-up measurement. After 8 weeks, SMDR was more successful than BoNT-A injection in diminishing VAS (VAS 80.0% vs 54.3%; drooling quotient 56.2% vs 51.0%). After 32 weeks, both drooling quotient (64.3% vs 29.5%) and VAS (75.7% vs 37.1%) showed significantly higher proportions of success for SMDR. Interpretation The effect of Submandibular BoNT-A injection does not predict subsequent SMDR success in drooling. Furthermore, SMDR has a larger and longer-lasting positive effect on drooling than BoNT-A injections. What this paper adds Submandibular botulinum neurotoxin A (BoNT-A) injection effect does not predict Submandibular Duct relocation with sublingual gland excision outcome. Submandibular Duct relocation is more effective and more permanent than BoNT-A injection.
-
Effectiveness of Submandibular Duct relocation in 91 children with excessive drooling: A prospective cohort study
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2018Co-Authors: Saskia E. Kok, Karen Van Hulst, Corrie E. Erasmus, Arthur R. T. Scheffer, Maroeska M. Rovers, Frank J. A. Van Den HoogenAbstract:Objective To evaluate the effectiveness of Submandibular Duct relocation (SMDR) in drooling children with neurological disorders. Design Prospective cohort study. Setting Academic Outpatient Saliva Control Clinic. Participants Ninety-one children suffering from moderate to severe drooling. Main outcome measures Direct observational drooling quotient (DQ; 0-100) and caretaker Visual Analogue Scale (VAS; 0-100). Secondary outcome measures were drooling severity (DS) and frequency rating scales. Results The DQ at baseline, 8 and 32 weeks postoperatively was 26.4, 12.3 and 10.8, respectively. VAS score decreased from 80.1 at baseline to 28.3 and 37.0 at 8 and 32 weeks after surgery. Median DS at baseline, 8 and 32 weeks was 5, 3 and 4, whereas the drooling frequency median scores were 4, 2 and 2, respectively. Five children required prolonged intubation due to transient floor of the mouth swelling, two of whom developed a ventilator-associated pneumonia. Another child developed atelectasis with postoperative pneumonia. Two more children needed tube feeding because of postoperative eating difficulties for 3 days or suprapubic catheterisation for urinary retention. Children aged 12 years or older (OR = 3.41; P = 0.03) and those with adequate stability and position of the head (OR = 2.84; P = 0.09) appeared to benefit most from treatment. Conclusions Submandibular Duct relocation combined with excision of the sublingual glands appears to be relatively safe and effective in diminishing visible drooling in children with neurological disorders, particularly in children aged 12 years and older and those without a forward head posture.
-
The impact of Submandibular Duct relocation on drooling and the well-being of children with neurodevelopmental disabilities
International journal of pediatric otorhinolaryngology, 2016Co-Authors: Saskia E. Kok, Karen Van Hulst, Corrie E. Erasmus, Jan J. W. Van Der Burg, Frank J. A. Van Den HoogenAbstract:Abstract Objective The aim of this study was to evaluate the impact of a reDuction in drooling after bilateral Submandibular Duct relocation (SMDR) with sublingual gland excision on daily life and care, as well as social and emotional consequences in children and adolescents with neurodevelopmental disabilities. Methods This prospective cohort study included 72 children and adolescents (46 males, 26 females) with moderate to severe drooling, and their caregivers. Mean age at the time of surgery was 15 years 2 months (SD 4y 3mo). Fifty-two children were diagnosed with cerebral palsy and 20 had other non-progressive developmental disabilities. A caregiver questionnaire to document the impact of drooling on daily care and economic consequences, social interaction and emotional development and self-esteem was administered before, and 8 and 32 weeks after surgery. Results Following bilateral SMDR the mean Visual Analogue Scale (VAS, 0–100) scores demonstrated a significant (p Conclusion Bilateral SMDR with sublingual gland excision provides a significant positive reDuction in daily care of children suffering from drooling. Caregivers also report positive changes in their child's social interaction and sense of self-esteem.
Arthur R. T. Scheffer - One of the best experts on this subject based on the ideXlab platform.
-
Submandibular Duct ligation after botulinum neurotoxin A treatment of drooling in children with cerebral palsy
Developmental medicine and child neurology, 2020Co-Authors: Stijn Bekkers, Ineke M J Pruijn, Karen Van Hulst, Corinne P. Delsing, Corrie E. Erasmus, Arthur R. T. Scheffer, Frank J. A. Van Den HoogenAbstract:Aim To assess: (1) the effect on drooling of bilateral Submandibular Duct ligation as surgical therapy after the administration of Submandibular botulinum neurotoxin A (BoNT-A) for excessive drooling and (2) the predictive value of treatment success with BoNT-A on treatment success after bilateral Submandibular Duct ligation. Method This was a within-participant retrospective observational study in which 29 children with severe drooling (15 males, 14 females) received BoNT-A treatment at a mean age of 9 years 6 months (SD 2y 5mo), followed by bilateral Submandibular Duct ligation at a mean age of 10 years 11 months (SD 2y 4mo). Fifteen children were diagnosed with cerebral palsy (CP), with 12 children classified in Gross Motor Function Classification System levels IV and V. The 14 children without CP had non-progressive developmental disorders. The primary drooling severity outcomes were the Visual Analogue Scale (VAS; subjective assessment) and drooling quotient (objective assessment). Measurements were taken before each intervention and again at 8 and 32 weeks. Results The VAS was significantly lower after bilateral Submandibular Duct ligation at follow-up compared to BoNT-A treatment (mean difference -33, p≤0.001; 95% confidence interval [CI]=-43.3 to -22.9). The mean drooling quotient did not significantly differ between BoNT-A treatment and bilateral Submandibular Duct ligation at follow-up (3.3, p=0.457; 95% CI=-4.35 to 9.62) or between 8 and 32 weeks (4.7, p=0.188; 95% CI=-2.31 to 11.65). Interpretation BoNT-A treatment and bilateral Submandibular Duct ligation are both effective treatment modalities for drooling. At 32-week follow-up, subjective drooling severity after bilateral Submandibular Duct ligation was significantly lower compared to previous BoNT-A injections in participants. However, treatment success with BoNT-A is no precursor to achieving success with bilateral Submandibular Duct ligation. What this paper adds Bilateral Submandibular Duct ligation is an effective therapy for drooling after treatment with botulinum neurotoxin A (BoNT-A). Treatment success with BoNT-A is not a predictor of successful therapy with bilateral Submandibular Duct ligation.
-
Effectiveness of Submandibular Duct relocation in 91 children with excessive drooling: A prospective cohort study
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2018Co-Authors: Saskia E. Kok, Karen Van Hulst, Corrie E. Erasmus, Arthur R. T. Scheffer, Maroeska M. Rovers, Frank J. A. Van Den HoogenAbstract:Objective To evaluate the effectiveness of Submandibular Duct relocation (SMDR) in drooling children with neurological disorders. Design Prospective cohort study. Setting Academic Outpatient Saliva Control Clinic. Participants Ninety-one children suffering from moderate to severe drooling. Main outcome measures Direct observational drooling quotient (DQ; 0-100) and caretaker Visual Analogue Scale (VAS; 0-100). Secondary outcome measures were drooling severity (DS) and frequency rating scales. Results The DQ at baseline, 8 and 32 weeks postoperatively was 26.4, 12.3 and 10.8, respectively. VAS score decreased from 80.1 at baseline to 28.3 and 37.0 at 8 and 32 weeks after surgery. Median DS at baseline, 8 and 32 weeks was 5, 3 and 4, whereas the drooling frequency median scores were 4, 2 and 2, respectively. Five children required prolonged intubation due to transient floor of the mouth swelling, two of whom developed a ventilator-associated pneumonia. Another child developed atelectasis with postoperative pneumonia. Two more children needed tube feeding because of postoperative eating difficulties for 3 days or suprapubic catheterisation for urinary retention. Children aged 12 years or older (OR = 3.41; P = 0.03) and those with adequate stability and position of the head (OR = 2.84; P = 0.09) appeared to benefit most from treatment. Conclusions Submandibular Duct relocation combined with excision of the sublingual glands appears to be relatively safe and effective in diminishing visible drooling in children with neurological disorders, particularly in children aged 12 years and older and those without a forward head posture.
-
botulinum toxin versus Submandibular Duct relocation for severe drooling
Developmental Medicine & Child Neurology, 2010Co-Authors: Arthur R. T. Scheffer, Karen Van Hulst, Corrie E. Erasmus, Peter H. Jongerius, Jacques Van Limbeek, Jan J. Rotteveel, Frank J. A. Van Den HoogenAbstract:Aim Botulinum neurotoxin type A (BoNT-A) has been described as an effective intervention for drooling and is being increasingly adopted. However, its effectiveness compared with established treatments is still unknown. We undertook a within-participants observational study to examine this. Method An historic cohort was formed of 19 children and young adults (10 males, nine females) with severe drooling who underwent BoNT-A injections followed by surgical re-routing of the Submandibular Duct at least 6 months later. Mean age at time of admission was 11 years 5 months (range 5–17y) and mean age at the time of surgery was 14 years (range 6–23y). Fifteen children were diagnosed with bilateral cerebral palsy (CP), three with unilateral CP, and one with non-progressive developmental delay. Gross Motor Function Classification System levels were the following: level I, n=1; level II, n=2; level III, n=7; level IV, n=6; and level V, n=3). The primary outcome was the drooling quotient, which was assessed before each intervention and 8 and 32 weeks thereafter. A multivariate analysis of variance of repeated measures was performed, with the measurement points as the within-participant variables. Results The drooling quotient was reduced to a greater extent after surgery than after BoNT-A administration (p=0.001). Compared with a baseline value of 28, the mean drooling quotient 8 weeks after surgery was 10, and 32 weeks after surgery was 4 (p<0.001). Among the group treated with BoNT-A, the drooling quotient showed a significant reDuction from a baseline value of 30 to 18 after 8 weeks (p=0.02), and a continued but diminished effect after 32 weeks (drooling quotient 22; p=0.05). Interpretation Both interventions are effective, but surgery provides a larger and longer-lasting effect.
-
Botulinum toxin versus Submandibular Duct relocation for severe drooling.
Developmental medicine and child neurology, 2010Co-Authors: Arthur R. T. Scheffer, Karen Van Hulst, Corrie E. Erasmus, Peter H. Jongerius, Jacques Van Limbeek, Jan J. Rotteveel, Frank J. A. Van Den HoogenAbstract:Aim Botulinum neurotoxin type A (BoNT-A) has been described as an effective intervention for drooling and is being increasingly adopted. However, its effectiveness compared with established treatments is still unknown. We undertook a within-participants observational study to examine this. Method An historic cohort was formed of 19 children and young adults (10 males, nine females) with severe drooling who underwent BoNT-A injections followed by surgical re-routing of the Submandibular Duct at least 6 months later. Mean age at time of admission was 11 years 5 months (range 5–17y) and mean age at the time of surgery was 14 years (range 6–23y). Fifteen children were diagnosed with bilateral cerebral palsy (CP), three with unilateral CP, and one with non-progressive developmental delay. Gross Motor Function Classification System levels were the following: level I, n=1; level II, n=2; level III, n=7; level IV, n=6; and level V, n=3). The primary outcome was the drooling quotient, which was assessed before each intervention and 8 and 32 weeks thereafter. A multivariate analysis of variance of repeated measures was performed, with the measurement points as the within-participant variables. Results The drooling quotient was reduced to a greater extent after surgery than after BoNT-A administration (p=0.001). Compared with a baseline value of 28, the mean drooling quotient 8 weeks after surgery was 10, and 32 weeks after surgery was 4 (p
J. Ricardo Martinez - One of the best experts on this subject based on the ideXlab platform.
-
Modulation of Ca2+ mobilization by protein kinase C in the Submandibular Duct cell line A253
Molecular and Cellular Biochemistry, 1999Co-Authors: Kenji Sugita, Ann-christin Mörk, Guo H. Zhang, J. Ricardo MartinezAbstract:The expression of protein kinase C (PKC) isoforms and the modulation of Ca^2+ mobilization by PKC were investigated in the human Submandibular Duct cell line A253. Three new PKC (nPKC) isoforms (δ, ε, and θ) and one atypical PKC (aPKC) isoform (λ) are expressed in this cell line. No classical PKC (cPKC) isoforms were present. The effects of the PKC activator phorbol 12-myristate-13-acetate (PMA) and of the PKC inhibitors calphostin C (CC) and bisindolymaleimide I (BSM) on inositol 1,4,5-trisphosphate (IP_3) and Ca^2+ responses to ATP and to thapsigargin (TG) were investigated. Pre-exposure to PMA inhibited IP_3 formation, Ca^2+ release and Ca^2+ influx in response to ATP. Pre-exposure to CC or BSM slightly enhanced IP_3 formation but inhibited the Ca^2+ release and the Ca^2+ influx induced by ATP. In contrast, pre-exposure to PMA did not modify the Ca^2+ release induced by TG, but reduced the influx of Ca^2+ seen in the presence of this Ca^2+-ATPase inhibitor. These results suggest that PKC modulates elements of the IP_3/Ca^2+ signal transDuction pathway in A253 cells by (1) inhibiting phosphatidylinositol turnover and altering the sensitivity of the Ca^2+ channels to IP_3, (2) altering the activity, the sensitivity to inhibitors, or the distribution of the TG-sensitive Ca^2+ ATPase, and (3) modulating Ca^2+ entry pathways.
-
Modulation of Ca2+ mobilization by protein kinase C in the Submandibular Duct cell line A253.
Molecular and Cellular Biochemistry, 1999Co-Authors: Kenji Sugita, Ann-christin Mörk, Guo H. Zhang, J. Ricardo MartinezAbstract:The expression of protein kinase C (PKC) isoforms and the modulation of Ca2+ mobilization by PKC were investigated in the human Submandibular Duct cell line A253. Three new PKC (nPKC) isoforms (δ, e, and θ) and one atypical PKC (aPKC) isoform (λ) are expressed in this cell line. No classical PKC (cPKC) isoforms were present. The effects of the PKC activator phorbol 12-myristate-13-acetate (PMA) and of the PKC inhibitors calphostin C (CC) and bisindolymaleimide I (BSM) on inositol 1,4,5-trisphosphate (IP3) and Ca2+ responses to ATP and to thapsigargin (TG) were investigated. Pre-exposure to PMA inhibited IP3 formation, Ca2+ release and Ca2+ influx in response to ATP. Pre-exposure to CC or BSM slightly enhanced IP3 formation but inhibited the Ca2+ release and the Ca2+ influx induced by ATP. In contrast, pre-exposure to PMA did not modify the Ca2+ release induced by TG, but reduced the influx of Ca2+ seen in the presence of this Ca2+-ATPase inhibitor. These results suggest that PKC modulates elements of the IP3/Ca2+ signal transDuction pathway in A253 cells by (1) inhibiting phosphatidylinositol turnover and altering the sensitivity of the Ca2+ channels to IP3, (2) altering the activity, the sensitivity to inhibitors, or the distribution of the TG-sensitive Ca2+ ATPase, and (3) modulating Ca2+ entry pathways.
-
Modulation of Ca2+ mobilization by protein kinase C in the Submandibular Duct cell line A253.
Molecular and cellular biochemistry, 1999Co-Authors: Kenji Sugita, Ann-christin Mörk, Guo H. Zhang, J. Ricardo MartinezAbstract:The expression of protein kinase C (PKC) isoforms and the modulation of Ca2+ mobilization by PKC were investigated in the human Submandibular Duct cell line A253. Three new PKC (nPKC) isoforms (delta, epsilon, and theta) and one atypical PKC (aPKC) isoform (lambda) are expressed in this cell line. No classical PKC (cPKC) isoforms were present. The effects of the PKC activator phorbol 12-myristate-13-acetate (PMA) and of the PKC inhibitors calphostin C (CC) and bisindolymaleimide I (BSM) on inositol 1,4,5-trisphosphate (IP3) and Ca2+ responses to ATP and to thapsigargin (TG) were investigated. Pre-exposure to PMA inhibited IP3 formation, Ca2+ release and Ca2+ influx in response to ATP. Pre-exposure to CC or BSM slightly enhanced IP3 formation but inhibited the Ca2+ release and the Ca2+ influx induced by ATP. In contrast, pre-exposure to PMA did not modify the Ca2+ release induced by TG, but reduced the influx of Ca2+ seen in the presence of this Ca2+-ATPase inhibitor. These results suggest that PKC modulates elements of the IP3/Ca2+ signal transDuction pathway in A253 cells by (1) inhibiting phosphatidylinositol turnover and altering the sensitivity of the Ca2+ channels to IP3, (2) altering the activity, the sensitivity to inhibitors, or the distribution of the TG-sensitive Ca2+ ATPase, and (3) modulating Ca2+ entry pathways.
-
Characterization of Ca2+ mobilization in the human Submandibular Duct cell line A253.
Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York N.Y.), 1997Co-Authors: Guo H. Zhang, R. J. Helmke, J. Ricardo MartinezAbstract:The regulation of Ca2+ mobilization in the human Submandibular Duct cell line A253 was investigated by monitoring cytosolic free Ca2+ concentrations ([Ca2+]i) using the Ca(2+)-sensitive fluorescent indicator fura-2 and by measuring inositol 1,4,5-triphosphate (IP3) formation. An increase in [Ca2+]i was elicited by ATP, isoproterenol (IPR), or vasoactive intestinal polypeptide (VIP), but not by acetylcholine, norepinephrine, or substance P, suggesting that Ca2+ mobilization is regulated by P2-purinergic, beta 2-adrenergic, and VIP receptors. 1,4,5-IP3 formation was significantly increased by ATP but not by the other agonists. Exposure of the cells to a membrane permeable cAMP analog, dibutyryl-cAMP, or to the adenylate cyclase activator forskolin induced a smaller increase in [Ca2+]i, indicating that the IPR-induced Ca2+ release is not mediated by cyclic AMP. Inhibition of the endoplasmic Ca(2+)-ATPase with thapsigargin (TG) in Ca(2+)-free medium induced a 207% increase in [Ca2+]i, and a subsequent exposure to ATP caused a further increase in [Ca2+]i of 104%. Similarly, TG exposure after ATP induced a further Ca2+ release, suggesting that the TG-sensitive store and the IP3-sensitive store do not overlap. Similar results were observed by sequential exposure to TG and IPR or to ATP and IPR. Ca2+ influx across the plasma membrane was enhanced after ATP or TG, but not after IPR. Our findings show a unique pattern of Ca2+ mobilization in the A253 cell line: (i) Ca2+ mobilization is regulated by P2-purinergic, beta 2-adrenergic, and VIP receptors; (ii) Ca2+ release is mediated by 1,4,5-IP3 and probably by an unknown mediator; (iii) TG, P2-, and beta 2-agonists discharge separate Ca2+ stores; and (iv) ATP and TG, but not IPR, regulate Ca2+ influx.
Karen Van Hulst - One of the best experts on this subject based on the ideXlab platform.
-
Submandibular Duct ligation after botulinum neurotoxin A treatment of drooling in children with cerebral palsy
Developmental medicine and child neurology, 2020Co-Authors: Stijn Bekkers, Ineke M J Pruijn, Karen Van Hulst, Corinne P. Delsing, Corrie E. Erasmus, Arthur R. T. Scheffer, Frank J. A. Van Den HoogenAbstract:Aim To assess: (1) the effect on drooling of bilateral Submandibular Duct ligation as surgical therapy after the administration of Submandibular botulinum neurotoxin A (BoNT-A) for excessive drooling and (2) the predictive value of treatment success with BoNT-A on treatment success after bilateral Submandibular Duct ligation. Method This was a within-participant retrospective observational study in which 29 children with severe drooling (15 males, 14 females) received BoNT-A treatment at a mean age of 9 years 6 months (SD 2y 5mo), followed by bilateral Submandibular Duct ligation at a mean age of 10 years 11 months (SD 2y 4mo). Fifteen children were diagnosed with cerebral palsy (CP), with 12 children classified in Gross Motor Function Classification System levels IV and V. The 14 children without CP had non-progressive developmental disorders. The primary drooling severity outcomes were the Visual Analogue Scale (VAS; subjective assessment) and drooling quotient (objective assessment). Measurements were taken before each intervention and again at 8 and 32 weeks. Results The VAS was significantly lower after bilateral Submandibular Duct ligation at follow-up compared to BoNT-A treatment (mean difference -33, p≤0.001; 95% confidence interval [CI]=-43.3 to -22.9). The mean drooling quotient did not significantly differ between BoNT-A treatment and bilateral Submandibular Duct ligation at follow-up (3.3, p=0.457; 95% CI=-4.35 to 9.62) or between 8 and 32 weeks (4.7, p=0.188; 95% CI=-2.31 to 11.65). Interpretation BoNT-A treatment and bilateral Submandibular Duct ligation are both effective treatment modalities for drooling. At 32-week follow-up, subjective drooling severity after bilateral Submandibular Duct ligation was significantly lower compared to previous BoNT-A injections in participants. However, treatment success with BoNT-A is no precursor to achieving success with bilateral Submandibular Duct ligation. What this paper adds Bilateral Submandibular Duct ligation is an effective therapy for drooling after treatment with botulinum neurotoxin A (BoNT-A). Treatment success with BoNT-A is not a predictor of successful therapy with bilateral Submandibular Duct ligation.
-
Submandibular gland botulinum neurotoxin A injection for predicting the outcome of Submandibular Duct relocation in drooling: a retrospective cohort study.
Developmental medicine and child neurology, 2019Co-Authors: Saskia E. Kok, Karen Van Hulst, Corrie E. Erasmus, Hans F J P Van Valenberg, Peter H. Jongerius, Frank J. A. Van Den HoogenAbstract:Aim This study evaluated whether the effect of Submandibular gland botulinum neurotoxin A (BoNT-A) injection can predict the outcome of Submandibular Duct relocation with sublingual gland excision (SMDR) in children with drooling. Furthermore, we compared the effectiveness of both procedures. Method A retrospective cohort study was performed in 42 children and adolescents (25 males, 17 females; mean [SD] age at BoNT-A injection 11y [4], range 4-20y; mean [SD] age at SMDR 15y [4], range 7-23y) with cerebral palsy or another non-progressive developmental disability who had undergone both BoNT-A injection and SMDR for drooling. Main outcomes were the drooling quotient and the visual analogue scale (VAS) on drooling severity at 8 weeks and 32 weeks follow-up. Results Failure or success of previous BoNT-A injections had no influence on success of consecutive SMDR. Relative change in main outcomes showed no significant relation between BoNT-A injection and SMDR for any follow-up measurement. After 8 weeks, SMDR was more successful than BoNT-A injection in diminishing VAS (VAS 80.0% vs 54.3%; drooling quotient 56.2% vs 51.0%). After 32 weeks, both drooling quotient (64.3% vs 29.5%) and VAS (75.7% vs 37.1%) showed significantly higher proportions of success for SMDR. Interpretation The effect of Submandibular BoNT-A injection does not predict subsequent SMDR success in drooling. Furthermore, SMDR has a larger and longer-lasting positive effect on drooling than BoNT-A injections. What this paper adds Submandibular botulinum neurotoxin A (BoNT-A) injection effect does not predict Submandibular Duct relocation with sublingual gland excision outcome. Submandibular Duct relocation is more effective and more permanent than BoNT-A injection.
-
Effectiveness of Submandibular Duct relocation in 91 children with excessive drooling: A prospective cohort study
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 2018Co-Authors: Saskia E. Kok, Karen Van Hulst, Corrie E. Erasmus, Arthur R. T. Scheffer, Maroeska M. Rovers, Frank J. A. Van Den HoogenAbstract:Objective To evaluate the effectiveness of Submandibular Duct relocation (SMDR) in drooling children with neurological disorders. Design Prospective cohort study. Setting Academic Outpatient Saliva Control Clinic. Participants Ninety-one children suffering from moderate to severe drooling. Main outcome measures Direct observational drooling quotient (DQ; 0-100) and caretaker Visual Analogue Scale (VAS; 0-100). Secondary outcome measures were drooling severity (DS) and frequency rating scales. Results The DQ at baseline, 8 and 32 weeks postoperatively was 26.4, 12.3 and 10.8, respectively. VAS score decreased from 80.1 at baseline to 28.3 and 37.0 at 8 and 32 weeks after surgery. Median DS at baseline, 8 and 32 weeks was 5, 3 and 4, whereas the drooling frequency median scores were 4, 2 and 2, respectively. Five children required prolonged intubation due to transient floor of the mouth swelling, two of whom developed a ventilator-associated pneumonia. Another child developed atelectasis with postoperative pneumonia. Two more children needed tube feeding because of postoperative eating difficulties for 3 days or suprapubic catheterisation for urinary retention. Children aged 12 years or older (OR = 3.41; P = 0.03) and those with adequate stability and position of the head (OR = 2.84; P = 0.09) appeared to benefit most from treatment. Conclusions Submandibular Duct relocation combined with excision of the sublingual glands appears to be relatively safe and effective in diminishing visible drooling in children with neurological disorders, particularly in children aged 12 years and older and those without a forward head posture.
-
The impact of Submandibular Duct relocation on drooling and the well-being of children with neurodevelopmental disabilities
International journal of pediatric otorhinolaryngology, 2016Co-Authors: Saskia E. Kok, Karen Van Hulst, Corrie E. Erasmus, Jan J. W. Van Der Burg, Frank J. A. Van Den HoogenAbstract:Abstract Objective The aim of this study was to evaluate the impact of a reDuction in drooling after bilateral Submandibular Duct relocation (SMDR) with sublingual gland excision on daily life and care, as well as social and emotional consequences in children and adolescents with neurodevelopmental disabilities. Methods This prospective cohort study included 72 children and adolescents (46 males, 26 females) with moderate to severe drooling, and their caregivers. Mean age at the time of surgery was 15 years 2 months (SD 4y 3mo). Fifty-two children were diagnosed with cerebral palsy and 20 had other non-progressive developmental disabilities. A caregiver questionnaire to document the impact of drooling on daily care and economic consequences, social interaction and emotional development and self-esteem was administered before, and 8 and 32 weeks after surgery. Results Following bilateral SMDR the mean Visual Analogue Scale (VAS, 0–100) scores demonstrated a significant (p Conclusion Bilateral SMDR with sublingual gland excision provides a significant positive reDuction in daily care of children suffering from drooling. Caregivers also report positive changes in their child's social interaction and sense of self-esteem.
-
botulinum toxin versus Submandibular Duct relocation for severe drooling
Developmental Medicine & Child Neurology, 2010Co-Authors: Arthur R. T. Scheffer, Karen Van Hulst, Corrie E. Erasmus, Peter H. Jongerius, Jacques Van Limbeek, Jan J. Rotteveel, Frank J. A. Van Den HoogenAbstract:Aim Botulinum neurotoxin type A (BoNT-A) has been described as an effective intervention for drooling and is being increasingly adopted. However, its effectiveness compared with established treatments is still unknown. We undertook a within-participants observational study to examine this. Method An historic cohort was formed of 19 children and young adults (10 males, nine females) with severe drooling who underwent BoNT-A injections followed by surgical re-routing of the Submandibular Duct at least 6 months later. Mean age at time of admission was 11 years 5 months (range 5–17y) and mean age at the time of surgery was 14 years (range 6–23y). Fifteen children were diagnosed with bilateral cerebral palsy (CP), three with unilateral CP, and one with non-progressive developmental delay. Gross Motor Function Classification System levels were the following: level I, n=1; level II, n=2; level III, n=7; level IV, n=6; and level V, n=3). The primary outcome was the drooling quotient, which was assessed before each intervention and 8 and 32 weeks thereafter. A multivariate analysis of variance of repeated measures was performed, with the measurement points as the within-participant variables. Results The drooling quotient was reduced to a greater extent after surgery than after BoNT-A administration (p=0.001). Compared with a baseline value of 28, the mean drooling quotient 8 weeks after surgery was 10, and 32 weeks after surgery was 4 (p<0.001). Among the group treated with BoNT-A, the drooling quotient showed a significant reDuction from a baseline value of 30 to 18 after 8 weeks (p=0.02), and a continued but diminished effect after 32 weeks (drooling quotient 22; p=0.05). Interpretation Both interventions are effective, but surgery provides a larger and longer-lasting effect.
