Comprehensive management of anterior drooling: An International Pediatric Otolaryngology Group (IPOG) consensus statement

Sam J Daniel; Pierre Fayoux; Neil Bateman; An Boudewyns; Matthew Brigger; Ching Yee Chan; Kenny Chan; Alan Cheng; Stephen Conley; Haytham Kubba; Elton M Lambert; Harlan Muntz; Roger Nuss; John Russell; Mike Rutter; Yehuda Schwarz; Jorge Spratley; Ravi Thevasagayam; Dana Thompson; Taher Valika; Michelle Wyatt

doi:10.1016/j.ijporl.2023.111500

Comprehensive management of anterior drooling: An International Pediatric Otolaryngology Group (IPOG) consensus statement

Int J Pediatr Otorhinolaryngol. 2023 May:168:111500. doi: 10.1016/j.ijporl.2023.111500. Epub 2023 Mar 9.

Authors

Sam J Daniel¹, Pierre Fayoux², Neil Bateman³, An Boudewyns⁴, Matthew Brigger⁵, Ching Yee Chan⁶, Kenny Chan⁷, Alan Cheng⁸, Stephen Conley⁹, Haytham Kubba¹⁰, Elton M Lambert¹¹, Harlan Muntz¹², Roger Nuss¹³, John Russell¹⁴, Mike Rutter¹⁵, Yehuda Schwarz¹⁶, Jorge Spratley¹⁷, Ravi Thevasagayam¹⁸, Dana Thompson¹⁹, Taher Valika²⁰, Michelle Wyatt²¹

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, McGill University Health Center, Montreal Children's Hospital, McGill University, Quebec, Canada. Electronic address: sam.daniel@mcgill.ca.
² Department of Otolaryngology - Head and Neck Surgery, CHU Lille, F-59000, Lille, France. Electronic address: pierre.fayoux@chu-lille.fr.
³ Department of Pediatric Otolaryngology, The University of Manchester, Royal Manchester Children's Hospital, England, UK. Electronic address: neildbateman@gmail.com.
⁴ Department of Otolaryngology - Head and Neck Surgery, University of Antwerp, Antwerp University Hospital, Belgium. Electronic address: an.boudewyns@uza.be.
⁵ Department of Otolaryngology - Head and Neck Surgery, UC San Diego School of Medicine, Rady Children's Hospital, San Diego, USA. Electronic address: mbrigger@rchsd.org.
⁶ Department of Otolaryngology, KK Women's and Children's Hospital, Singapore. Electronic address: chan.ching.yee@singhealth.com.sg.
⁷ Department of Otolaryngology - Head and Neck Surgery, University of Colorado School of Medicine, Children's Hospital Colorado, USA. Electronic address: kenny.chan@childrenscolorado.org.
⁸ Department of Pediatric Otolaryngology, The University of Sydney, The Sydney Children's Hospital Network- Westmead Campus, Sydney, Australia. Electronic address: atlcheng2008@gmail.com.
⁹ Department of Otolarynology & Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: sfconley@mcw.edu.
¹⁰ Department of Otolaryngology, University of Glasgow, Glasgow Children's Hospital, Glasgow, Scotland, UK. Electronic address: haytham.kubba@glasgow.ac.uk.
¹¹ Department of Otolaryngology, Baylor College of Medicine, Texas Children's Hospital, Texas, USA. Electronic address: emashela@texaschildrens.org.
¹² Department of Otolaryngology, UC Davis Children's Hospital, Sacramento, CA, USA. Electronic address: pchmuntz@gmail.com.
¹³ Division of Pediatric Otolaryngology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: roger.nuss@childrens.harvard.edu.
¹⁴ Department of Otolaryngology, Children's Health Ireland(CHI) at Crumlin, Dublin, Ireland. Electronic address: john@drjrussellent.com.
¹⁵ Department of Otolaryngology- Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Electronic address: mike.rutter@cchmc.org.
¹⁶ Department of Otolaryngology- Head and Neck Surgery, Shaare Zedek Medical Center, Jerusalem, Israel. Electronic address: yehuda.schwarz@yahoo.com.
¹⁷ Pediatric Otorhinolaryngology, University of Porto Faculty of Medicine, S. Joao Hospital Center, CINTESIS, Porto, Portugal. Electronic address: jorge.spratley@gmail.com.
¹⁸ Department of Paediatric Otolaryngology, Sheffield Children's Hospital, UK. Electronic address: ravi.theva@nhs.net.
¹⁹ Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA. Electronic address: dmthompson@luriechildrens.org.
²⁰ Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, USA. Electronic address: tvalika@luriechildrens.org.
²¹ Paediatric Otolaryngologist, Great Ormond Street Hospital, London, England, UK. Electronic address: Michelle.wyatt@gosh.nhs.uk.

PMID: 36990032
DOI: 10.1016/j.ijporl.2023.111500

Abstract

Objective: To provide guidance for the comprehensive management of children referred for anterior drooling. The mission of the International Pediatric Otolaryngology Group (IPOG) is to develop expertise-based recommendations for the management of pediatric otolaryngologic disorders with the goal of improving patient care.

Methods: Survey of expert opinion by the members of the International Pediatric Otolaryngology Group (IPOG). The recommendations are derived from current expert consensus and critical review of the literature.

Results: Consensus recommendations include initial care and approach recommendations for health care providers who commonly evaluate children with drooling. This includes evaluation and treatment considerations for commonly debated issues in drooling management, initial work-up of children referred for anterior drooling, treatment recommendations, indications and contra-indications for rehabilitation, medical, and surgical management, as well as pros and cons of different surgical procedures in the hands of drooling management experts.

Conclusion: Anterior drooling consensus recommendations are aimed at improving patient-centered care in children referred for sialorrhea.

Keywords: Botulinum toxin; Complications; Drooling; Management; Sialorrhea; Surgery.

Publication types

Review

MeSH terms

Botulinum Toxins, Type A*
Child
Consensus
Humans
Otolaryngology*
Sialorrhea* / surgery

Substances

Botulinum Toxins, Type A