{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:39:48Z","timestamp":1784302788824,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Sialorrhea, also known as drooling, hypersalivation, or ptyalism, has a significant impact on the medical and psychosocial well\u2010being of children. Onabotulinum toxin A (BoNT\u2010A) is the most commonly used botulinum toxin worldwide for the treatment of sialorrhea in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To conduct a comprehensive systematic review and meta\u2010analysis to assess the clinical efficacy and potential adverse effects of BoNT\u2010A as a treatment for drooling in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cochrane, Embase, and Medline databases were systematically searched (up to May 2023). Out of 535 identified publications, 20 were found eligible for inclusion. A systematic review and meta\u2010analysis were performed to determine the efficacy of BoNT\u2010A treatment in children in reducing the frequency and severity of drooling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of the 20 studies included, a meta\u2010analysis was conducted on the complete dataset of eight studies involving 131 patients. BoNT\u2010A was found to significantly decrease the severity of drooling in patients with sialorrhea (standardized mean difference [SMD], \u22122.07; 95% confidence interval [CI], \u22122.91 to \u22121.23; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) when compared with the conditions before injections using random\u2010effects models. Six studies out of 20 reported dysphagia as an adverse effect after injection. Other side effects included thickness of saliva and pain at the site of injection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BoNT\u2010A is a clinically effective therapy that improves drooling severity in children with sialorrhea. Although there were some adverse side effects reported, they were transient and not severe. Future studies are needed to further evaluate the best techniques and to identify the ideal dosages required to achieve the optimal outcomes. <jats:italic>Laryngoscope<\/jats:italic>, 134:3012\u20133017, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31277","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T14:29:01Z","timestamp":1706711341000},"page":"3012-3017","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Onabotulinum Toxin A (BoNT\u2010A) for Drooling in Children: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"134","author":[{"given":"Haresh","family":"Oad","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alix","family":"Maltezeanu","sequence":"additional","affiliation":[{"name":"Department 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