{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T17:50:04Z","timestamp":1764784204160,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,3,10]],"date-time":"2019-03-10T00:00:00Z","timestamp":1552176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>This study evaluated whether the effect of submandibular gland botulinum neurotoxin A (Bo<jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\u2010A) injection can predict the outcome of submandibular duct relocation with sublingual gland excision (<jats:styled-content style=\"fixed-case\">SMDR<\/jats:styled-content>) in children with drooling. Furthermore, we compared the effectiveness of both procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective cohort study was performed in 42 children and adolescents (25 males, 17 females; mean [<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>] age at Bo<jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\u2010A injection 11y [4], range 4\u201320y; mean [<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>] age at <jats:styled-content style=\"fixed-case\">SMDR<\/jats:styled-content> 15y [4], range 7\u201323y) with cerebral palsy or another non\u2010progressive developmental disability who had undergone both Bo<jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\u2010A injection and <jats:styled-content style=\"fixed-case\">SMDR<\/jats:styled-content> for drooling. Main outcomes were the drooling quotient and the visual analogue scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>) on drooling severity at 8 weeks and 32 weeks follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Failure or success of previous Bo<jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\u2010A injections had no influence on success of consecutive <jats:styled-content style=\"fixed-case\">SMDR<\/jats:styled-content>. Relative change in main outcomes showed no significant relation between Bo<jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\u2010A injection and <jats:styled-content style=\"fixed-case\">SMDR<\/jats:styled-content> for any follow\u2010up measurement. After 8 weeks, <jats:styled-content style=\"fixed-case\">SMDR<\/jats:styled-content> was more successful than Bo<jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\u2010A injection in diminishing <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> 80.0% vs 54.3%; drooling quotient 56.2% vs 51.0%). After 32 weeks, both drooling quotient (64.3% vs 29.5%) and <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> (75.7% vs 37.1%) showed significantly higher proportions of success for <jats:styled-content style=\"fixed-case\">SMDR<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>The effect of submandibular Bo<jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\u2010A injection does not predict subsequent <jats:styled-content style=\"fixed-case\">SMDR<\/jats:styled-content> success in drooling. Furthermore, <jats:styled-content style=\"fixed-case\">SMDR<\/jats:styled-content> has a larger and longer\u2010lasting positive effect on drooling than Bo<jats:styled-content style=\"fixed-case\">NT<\/jats:styled-content>\u2010A injections.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Submandibular botulinum neurotoxin A (BoNT\u2010A) injection effect does not predict submandibular duct relocation with sublingual gland excision outcome.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Submandibular duct relocation is more effective and more permanent than BoNT\u2010A injection.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14199","type":"journal-article","created":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T06:39:43Z","timestamp":1552286383000},"page":"1323-1328","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Submandibular gland botulinum neurotoxin A injection for predicting the outcome of submandibular duct relocation in drooling: a retrospective cohort study"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4773-5461","authenticated-orcid":false,"given":"Saskia E","family":"Kok","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Radboud University Nijmegen Medical Center Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans F J P","family":"van Valenberg","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Radboud University Nijmegen Medical Center Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9456-3450","authenticated-orcid":false,"given":"Karen","family":"van Hulst","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Radboud University Nijmegen Medical Center Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Jongerius","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rehabilitation Sint Maartenskliniek Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrie E","family":"Erasmus","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurology Radboud University Nijmegen Medical Center Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank J A","family":"van den Hoogen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Radboud University Nijmegen Medical Center Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2010.03131.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e328011014a"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.03243.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/4.6.406"},{"key":"e_1_2_7_6_1","first-page":"691","article-title":"Drooling in children with cerebral palsy","volume":"34","author":"Van De Heyning PH","year":"1980","journal-title":"Acta Otorhinolaryngol 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