{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T19:11:56Z","timestamp":1776625916877,"version":"3.51.2"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"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":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Children with type I laryngeal clefts and sialorrhea can have posterior drooling, aspiration of oral secretions, and respiratory complications. Laryngeal cleft injection laryngoplasty (LCIL) and salivary botulinum injections (Sal\u2010Bot) have been used separately for short\u2010term treatment of type I laryngeal clefts and sialorrhea. Our goal was to evaluate combined LCIL and Sal\u2010Bot and create recommendations for further treatment based on response to initial treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective chart review of nine patients who underwent direct laryngoscopy and bronchoscopy with combined LCIL and Sal\u2010Bot from 2012 to 2019. Charts were reviewed for patient characteristics, response to treatment, and pre and post\u2010op hospitalizations. Subsequent procedures were performed depending on efficacy of initial treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine patients were identified. All had pre\u2010existing neurologic conditions, gastrostomy tubes, and a history of coughing and choking on secretions. Only one patient was able to feed orally (purees). 1\u00a0U\/kg of botulinum toxin per gland was injected into each parotid and submandibular gland. The average units of botulinum toxin injected was 67\u2009U. The mean laryngeal cleft injection volume was 0.35\u2009cc. Subsequent treatment was based on timing of symptomatic improvement and individual patient factors. Five patients had respiratory\u2010related hospitalizations in year preceding the procedures (median 1.5, range 1\u201310). Three (60%) had a reduction in respiratory\u2010related hospitalization 1\u00a0year post procedure (median 1, range 1\u20133). One patient died during the follow up period due to continued chronic respiratory failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is the first study of combined laryngeal cleft injection laryngoplasty and botulinum toxin injections for patients with posterior laryngeal penetration and aspiration of oropharyngeal secretions. We highlight strategies for choosing subsequent procedures based on response to initial treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.823","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T11:19:27Z","timestamp":1653909567000},"page":"1194-1199","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Combined laryngeal cleft injection laryngoplasty and salivary botulinum toxin for saliva aspiration"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5520-3273","authenticated-orcid":false,"given":"Justin","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Otolaryngology: Head and Neck Surgery Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8621-5456","authenticated-orcid":false,"given":"Julina","family":"Ongkasuwan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head and Neck Surgery Baylor College of Medicine  Houston Texas USA"},{"name":"Division of Pediatric Otolaryngology, Department of Surgery Texas Children's Hospital  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Anand","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology, Department of Surgery Texas Children's Hospital  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elton M.","family":"Lambert","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head and Neck Surgery Baylor College of Medicine  Houston Texas USA"},{"name":"Division of Pediatric Otolaryngology, Department of Surgery Texas 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