1 - Serviço de Medicina Física e de Reabilitação, Área de Pediatria, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
2 - Serviço de Medicina Física e de Reabilitação, Centro Hospitalar Baixo Vouga
3 - Serviço de Medicina Física e de Reabilitação, Área de Pediatria, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- Reunião Nacional - Comunicação oral no XXIII Congresso Nacional da SPMFR 2023 – Prémio de Menção Honrosa
- Publicação em versão integral - Pires M, Saldanha J, Claro S (September 16, 2023) Ultrasound Guidance Superiority in Pediatric Sialorrhea Treatment With Intraglandular Botulinum Toxin Application: A Four-Year Retrospective Study. Cureus 15(9): e45359. DOI 10.7759/cureus.45359
- Reuniao Internacional - Poster – 35th Annual Meeting of the European Academy of Childhood Disability, 2023
Introduction: The management of sialorrhea in children with multiple disabilities is extremely important not only for aesthetic/psychosocial reasons but also for functional and clinical ones. There are several recommended management methods with strong evidence of the effectiveness of intraglandular application of botulinum toxin A.
Materials and methods: In this four-year retrospective report, we compare two populations who received intraglandular type A botulinum toxin injections in the pediatric unit of the Physical Medicine and Rehabilitation (PM&R) Department at a central hospital. The injections were administered using either ultrasound guidance (US) or anatomical landmarks.
Results: Out of a total of 29 patients with neurological conditions, 16 met the eligibility criteria for this study. The study group comprised seven females (44%) and nine males (56%), with a median age of 9 years. The average pre-procedure sialorrhea staging was four. A total of 23 procedures were performed, with 16 conducted under ultrasound guidance (US) and seven via anatomical landmarks (non-US). In the US group, a statistically significant difference in sialorrhea staging was observed at one and three months postprocedure (p<0.05), but not at six months post-procedure. Conversely, no statistically significant difference in sialorrhea staging was found at any time point in the non-US group. The comparison between the two groups supports the use of ultrasound guidance, showing superior outcomes at one and three months postprocedure (p<0.05).
Conclusion: The results of this study align with global trends seen in medical publications and guidelines advocating for the use of ultrasound in this procedure. Future prospective and larger-scale studies are essential to validate these findings.
Palavras Chave: botulinum neurotoxin type-a, botulinum toxin injection, ultrasonography, pediatric, sialorrhea