Current Aspects of Treatment Options of Chronic Sialorrhea in Children

Abstract

Sialorrhea in children is not a primary disease, but the sequela of an existing underlying disease [1-48]. Excessive salivation frequently occurs in children suffering from cerebral palsy (rates between 10% and 58%) [1, 4, 5, 7, 11, 14, 18, 22, 33-35, 39, 40, 42, 43]. This is caused by early brain damage before or at birth or in infancy, which becomes apparent in the first years of life in physical limitations and reduced intelligence [2, 3, 6, 8-10]. Depending on the severity of the disease, the affected children suffer from movement disorders, swallowing difficulties and lack of control over certain muscle groups in the mouth area, among other things [1-49]. Other neurological disorders, such as severe craniocerebral injuries, as well as several developmental disorders can also lead to chronic sialorrhea [1, 4, 5, 7, 11, 14, 18, 22, 33-35, 39, 40, 42, 43]. Hypersalivation refers to a relatively or absolutely excessive flow of saliva, which can lead to wetting of the lips, chin, hands, the surrounding area and to the entry of saliva into the deep airways to varying degrees due to insufficient orofacial abilities and/or a disturbance of sensorimotor control of the swallowing process. This complaint often occurs as an accompanying symptom in patients with a variety of neurological diseases, which may be acute, such as stroke, traumatic brain injury, meningoencephalitis, Guillain-Barre syndrome, critical illness polyneuropathy, and tumors [3, 4, 14]. Nevertheless, autoimmune diseases like multiple sclerosis, myositis and myasthenia, neurodegenerative diseases like amyotrophic lateral sclerosis, Parkinson syndromes as well as muscle diseases lead to hypersalivation [3, 4, 14]. In children, cerebral palsy and several congenital syndromes are associated with sometimes significantly increased salivation [1, 4, 5, 7, 11, 14, 18, 22, 33-35, 39, 40, 42, 43]. The wide range of genesis and the multifactorial aspects of the underlying diseases have led to many studies on the treatment of hypersalivation in recent years, but with little robust evidence