{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:40:04Z","timestamp":1790948404033,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"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":[[2021,9]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the effect of botulinum neurotoxin A (BoNT\u2010A) injections, submandibular gland excision (SMGE), and bilateral submandibular duct ligation (2DL) for the control of posterior drooling in children with neurological impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In a retrospective cohort, children with neurological impairment (e.g. cerebral palsy) treated between 2000 and 2016 were identified. Mean age at time of surgery was 9 years (range 1\u201321y). The primary outcome was posterior drooling severity by a visual analogue scale (VAS; 0\u201310) at baseline, 8\u2010weeks, and 32\u2010weeks follow\u2010up. The secondary outcome was lower respiratory tract infections during the follow\u2010up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010two patients (out of 475; 47 males, 45 females) were identified. They were undergoing three different treatments: BoNT\u2010A (<jats:italic>n<\/jats:italic>=63), SMGE (<jats:italic>n<\/jats:italic>=16), and 2DL (<jats:italic>n<\/jats:italic>=13). A significant reduction in VAS over time was observed in the total group of 92 patients. After SMGE, VAS decreased significantly from 6.82 (SD 3.40) at baseline to 2.29 (SD 1.93) at 8 weeks, and 2.17 (SD 2.58) at 32 weeks (<jats:italic>F<\/jats:italic>[2.34]=11.618, <jats:italic>p<\/jats:italic>&lt;0.001). There was no significant decrease after both BoNT\u2010A and 2\u2010DL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Posterior drooling is an unfamiliar, potentially life\u2010threatening condition that is treatable with medication, BoNT\u2010A injections, or surgery. Although all treatments reduced signs and symptoms of posterior drooling, there is a greater effect after SMGE compared to BoNT\u2010A and 2\u2010DL.<\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p>\n<jats:boxed-text content-type=\"box\" position=\"anchor\"><jats:caption><jats:title>What this paper adds<\/jats:title><\/jats:caption><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Submandibular gland excision has better results for posterior drooling than botulinum toxin A or submandibular duct ligation.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:boxed-text>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14888","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T18:12:25Z","timestamp":1618251145000},"page":"1093-1098","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Posterior drooling in children with cerebral palsy and other neurodevelopmental disorders"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7587-9791","authenticated-orcid":false,"given":"Corinne PA","family":"Delsing","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Institute for Health Sciences Radboud University Medical Centre Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8330-9243","authenticated-orcid":false,"given":"Stijn","family":"Bekkers","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Institute for Health Sciences Radboud University Medical Centre Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6657-941X","authenticated-orcid":false,"given":"Corrie E","family":"Erasmus","sequence":"additional","affiliation":[{"name":"Department of Pediatric 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