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Updated: May 20, 2026
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Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
Published on: November 9, 2016
US-guided botulinum toxin injection for excessive drooling in children
Türkmen Çiftçi1, Devrim Akıncı, Nursel Yurttutan
1Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey. turkmenciftci@yahoo.com
Diagnostic and Interventional Radiology (Ankara, Turkey)
|July 17, 2012
Summary
Ultrasonography-guided botulinum toxin A injections safely and effectively reduced excessive drooling in children. This treatment, performed under sedation, offers a viable alternative to surgery for pediatric sialorrhea.
Area of Science:
- Pediatric Otolaryngology
- Neurology
- Medical Imaging
Background:
- Excessive drooling, or sialorrhea, is a common challenge in children with neurological or developmental disorders.
- Traditional treatments for severe drooling can be invasive or have significant side effects.
Purpose of the Study:
- To evaluate the safety and efficacy of botulinum toxin A (BTX-A) injections guided by ultrasonography (US) for treating excessive drooling in children.
- To determine if US-guided BTX-A injections can be performed safely under intravenous sedation.
Main Methods:
- 20 children with excessive drooling received 44 BTX-A injections into their submandibular glands under US guidance and sedation.
- Efficacy was assessed using the Teacher Drooling Scale (TDS) 4-12 weeks post-injection.
- Injections were repeated if drooling returned to baseline levels; non-responders received a booster or were considered for surgery.
Main Results:
- 100% technical success rate with no major complications.
- 80% of patients achieved clinical success (≥2 point reduction in TDS) by 12 weeks.
- Mean TDS score decreased significantly from 4.75 to 2.1; 4 patients did not respond to BTX-A.
Conclusions:
- Ultrasonography-guided BTX-A injection is a safe and effective treatment for pediatric sialorrhea.
- The procedure can be performed effectively under intravenous sedation, avoiding the need for general anesthesia.
- BTX-A offers a minimally invasive option for managing excessive drooling in children.
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