{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:48:07Z","timestamp":1787014087613,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate negative effects on oral motor function after concurrent submandibular and parotid (four\u2010gland) botulinum neurotoxin A (BoNT\u2010A) injections as a treatment for paediatric drooling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This was a retrospective cohort study of 125 children (median age 7\u2009years 7\u2009months [interquartile range 4\u2009years 5\u2009months]) with developmental disabilities, including cerebral palsy, treated with four\u2010gland injections. Most children (90.4%) were previously exposed to submandibular injections. Frequency, severity, and duration of negative effects on oral motor function (i.e. saliva swallowing, eating, drinking, articulation) were evaluated and compared to a reference cohort treated with submandibular injections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Negative effects on oral motor function were reported in 45 children (36.0%), predominantly manifesting as eating\u2010related problems (64.4%). Most negative effects (62.2%) were classified as mild and resolved within 4\u2010weeks post\u2010injunction (53.3%). Compared to the reference cohort, frequency (36.0% vs 33.0%) and duration (53.3% vs 53.6% resolving within 4\u2009weeks) of negative effects were comparable, although problems were more often moderately severe (33.3% vs 10.1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>While negative effects on oral motor function were relatively common after four\u2010gland BoNT\u2010A injections, most problems were mild and resolved promptly. No substantial differences to a reference cohort treated with submandibular injections were observed, although further research should establish the generalizability of these findings in a treatment\u2010naive population. Nevertheless, when submandibular injections prove ineffective, clinicians can confidently consider four\u2010gland injections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dmcn.16131","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T14:03:25Z","timestamp":1729778605000},"page":"656-664","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Negative effects on oral motor function after submandibular and parotid botulinum neurotoxin A injections for drooling in children with developmental disabilities"],"prefix":"10.1111","volume":"67","author":[{"given":"Reva M.","family":"van Eck","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Division of Paediatric Neurology Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital  Nijmegen the Netherlands"},{"name":"Faculty of Medical Sciences Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0561-4768","authenticated-orcid":false,"given":"Lynn B.","family":"Orri\u00ebns","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Division of Paediatric Neurology Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Amalia Children's Hospital  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7587-9791","authenticated-orcid":false,"given":"Corinne P. A.","family":"Delsing","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\/Head and Neck Surgery Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2935-5599","authenticated-orcid":false,"given":"Frank J. 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