Posterior drooling in children with cerebral palsy and other neurodevelopmental disorders.

Aim: To evaluate the effect of botulinum neurotoxin A (BoNT-A) injections, submandibular gland excision (SMGE), and bilateral submandibular duct ligation (2DL) for the control of posterior drooling in children with neurological impairment.

Method: In a retrospective cohort, children with neurological impairment (e.g.

Repeated onabotulinum neurotoxin A injections for drooling in children with neurodisability.

Aim: To evaluate the effect of repeated onabotulinum neurotoxin A injections for the treatment of drooling in children with neurodisabilities.

Method: This was a retrospective cohort study, in which the first, second, and third onabotulinum neurotoxin A injection were compared within children treated between 2000 and 2020. Primary outcomes included drooling quotient, visual analogue scale (VAS), and treatment success defined as ≥50% reduction in drooling quotient and/or VAS 8 weeks after treatment.

The impact of submandibular duct relocation on drooling and the well-being of children with neurodevelopmental disabilities.

Objective: The aim of this study was to evaluate the impact of a reduction in drooling after bilateral submandibular duct relocation (SMDR) with sublingual gland excision on daily life and care, as well as social and emotional consequences in children and adolescents with neurodevelopmental disabilities.

Methods: This prospective cohort study included 72 children and adolescents (46 males, 26 females) with moderate to severe drooling, and their caregivers. Mean age at the time of surgery was 15 years 2 months (SD 4y 3mo).

Bilateral transcervical submandibular gland excision for drooling: A study of the mature scar and long-term effects.

Aim: Several surgical techniques are available to treat drooling in neurologically disabled children and adolescents, with bilateral submandibular gland excision being the only transcervical procedure. External scars can be a reason to decline for this surgical approach. We investigated which factors influenced caregiver satisfaction by evaluating the long-term scar in relation to treatment outcome.

Outcomes of endoscopic cricopharyngeal myotomy with CO2 laser surgery: A retrospective study of 47 patients.

Background: Endoscopic cricopharyngeal myotomy (ECPM) using CO2 laser surgery presents a less invasive treatment technique when compared to transcervical cricopharyngeal myotomy.

Methods: Forty-seven patients who underwent ECPM from 2002 until 2013 were included in this study. Patient characteristics, and preoperative and postoperative outcome and complications were scored by retrospective chart review and by using the Deglutition Handicap Index (DHI).

[The treatment of drooling in children].

Undesirable drooling in children is an underexposed problem and difficult to treat, although there are multiple treatment options. A multidisciplinary approach is preferable for the examination and treatment of patients with drooling. The injection of botulinum toxin is the most frequently performed treatment for children who drool, but the effects are temporary.

Recurrences after thyroglossal duct cyst surgery: Results in 207 consecutive cases and review of the literature.

Background: A thyroglossal duct cyst is the most common form of congenital anomaly in the neck. Surgical removal is very effective. However, in some cases, a cyst recurs.

Pathology-based validation of FDG PET segmentation tools for volume assessment of lymph node metastases from head and neck cancer.

Purpose: FDG PET is increasingly incorporated into radiation treatment planning of head and neck cancer. However, there are only limited data on the accuracy of radiotherapy target volume delineation by FDG PET. The purpose of this study was to validate FDG PET segmentation tools for volume assessment of lymph node metastases from head and neck cancer against the pathological method as the standard.

[Cranial nerve palsy caused by tumours of the head and neck].

Cranial nerve palsy is a diagnostic guiding symptom, but often goes unrecognized. The differential diagnosis includes a variety of diseases, including malignant tumours of the head and neck. Here we describe three cases of cranial nerve palsy.

[Chronic unilateral rhinorrhea in childhood].

A 13-year-old patient was referred to the ENT department because of a ring-shaped radiopaque foreign body in her right nasal cavity demonstrated on an orthopantomogram. Her medical history revealed long-standing right-sided rhinorrhea thought to be caused by an inhalation allergy. In case of unilateral rhinorrhea in a child a nasal foreign body has to be excluded.

Oral squamous cell carcinoma and a clinically negative neck: the value of follow-up.

Background: In squamous cell carcinoma of the oral cavity (SCCOC), regular follow-up comprises 5 years of prescheduled visits, irrespective of tumor stage/classification and/or treatment. We analyzed our standard treatment and follow-up protocol in patients with a preoperative clinically negative neck (cN0) in SCCOC.

Methods: This is a retrospective chart analysis.

What could predict effectiveness of Botulinum Toxin to treat drooling: a search for evidence of discriminatory factors on the level of body functions or structures.

Background: The treatment of drooling is important to families that experience the daily impact and research to elucidate clinical factors that play a role in the outcome of drooling treatment should be encouraged.

Aim: To define clinical factors that influence therapy outcome of submandibular Botulinum Toxin (BoNT-A) injections for drooling.

Methods: Prospectively collected data of 128 children with cerebral palsy were evaluated; 80 spastic and 48 dyskinetic movement disorder, mostly Gross Motor Function Classification System III and higher; over 70% had an IQ <70.

Does motor performance matter in botulinum toxin efficacy for drooling?

The aim of this study was to define factors that influence therapy outcome of submandibular botulinum toxin injections for drooling in children with cerebral palsy or mental disability. We postulated that differences in response may be explained by the variation of dysfunctions in the various cerebral palsy subtypes. Prospectively collected data were evaluated of 80 spastic and 48 dyskinetic children, of whom 70% had an IQ of <70.

A prospective randomized multicenter clinical trial of the Provox2 and Groningen Ultra Low Resistance voice prostheses in the rehabilitation of post-laryngectomy patients: a lifetime and preference study.

To prospectively study patients' preference for and the lifetime of the Groningen Ultra Low Resistance (GULR) and Provox2 tracheo-esophageal shunt prosthesis (TESP, plural TESPs) in post-laryngectomy patients. Eighty post-laryngectomy patients were included in 4 oncological centers in the Netherlands. We used a repeated measures design study with 4 randomized groups in a partial cross-over design using 3 consecutive TESPs (3 intervals) in different orders.

Early and late outcome after single step dilatational tracheostomy versus the guide wire dilating forceps technique: a prospective randomized clinical trial.

Purpose: Percutaneous tracheostomy is frequently performed in long-term ventilated patients in the intensive care unit (ICU). Unfortunately, despite many years of experience, the optimal technique is still unknown, especially considering the occurrence of late complications. The purpose of this study was to determine which of the two most frequently used percutaneous tracheostomy techniques performs best with the emphasis on late complications.

Endolymphatic sac tumors: clinical outcome and management in a series of 9 cases.

Objectives: Endolymphatic sac tumors (ELSTs) are rare adenomatous tumors arising in the petrous bone, either spontaneously (isolated) or in association with von Hippel-Lindau (VHL) disease. For 9 patients, this study describes the typical features and management of ELST and the clinical outcome of treatment. Similarities and differences are identified for ELST in isolation and in association with VHL disease.

Efficacy and duration of botulinum toxin treatment for drooling in 131 children.

Objective: To address the efficacy of botulinum toxin and the duration of its effect when used on a large scale for the treatment of drooling in children with neurological disorders.

Design: Prospective cohort study.

Setting: Academic multidisciplinary drooling clinic.

Endoscopic carbon dioxide laser diverticulostomy versus endoscopic staple-assisted diverticulostomy to treat Zenker's diverticulum.

Background: The 2 most frequently used endoscopic methods to treat Zenker's diverticulum are staple-assisted and CO(2) laser esophagodiverticulostomy.

Methods: The study centered around a retrospective evaluation of 107 patients with Zenker's diverticulum who were treated endoscopically by CO(2) laser (n = 72) or staple-assisted diverticulostomy (n = 35).

Results: Patients in the staple-assisted group had a shorter duration of postoperative hospitalization, attributed to earlier oral intake, than patients in the CO(2) laser group.

Botulinum toxin versus submandibular duct relocation for severe drooling.

Aim: Botulinum neurotoxin type A (BoNT-A) has been described as an effective intervention for drooling and is being increasingly adopted. However, its effectiveness compared with established treatments is still unknown. We undertook a within-participants observational study to examine this.

[A girl with a swelling on her forehead].

A 9-year-old girl presented with headache and swelling of her forehead caused by a Pott's puffy tumour.

Thickened saliva after effective management of drooling with botulinum toxin A.

Aim: The aim of this study was to evaluate the rheological properties of saliva after submandibular botulinum toxin type A (BoNT-A) injections.

Method: We enrolled 15 children (11 males and six females; age range 3-17 y, mean age 9 y 10 mo) diagnosed with spastic (n=9) or dyskinetic (n=6) quadriplegic cerebral palsy (CP); Gross Motor Function Classification System level IV or V; and two children with intellectual disability (IQ<70) who experienced moderate to severe drooling. Salivary flow rate and drooling quotient were measured at baseline and at different times after BoNT-A injections up to 24 weeks.

Impact of an integrated care program for patients with head and neck cancer on the quality of care.

Background: The management of patients with head and neck cancer is complex, and implementation of an integrated care program might improve the quality of care.

Methods: A prospective before-after study was performed in 1 clinic for head and neck oncology on 311 adults with head and neck cancer to evaluate an integrated care program.

Results: Scores on the integrated care indicators showed that the implementation of the integrated care program led to relevant improvements, eg, waiting time for diagnostic procedures less than 10 days (improvement of 37%), support for stopping smoking (+37%), nutrition support (+44%), assessment of CT and MRI scans by a an expert radiologist (+23%), and number of patients in contact with the specialist nurses (+37%).

Drooling in cerebral palsy: hypersalivation or dysfunctional oral motor control?

Aim: To investigate whether drooling in children with cerebral palsy (CP) in general and in CP subtypes is due to hypersalivation.

Method: Saliva was collected from 61 healthy children (30 males, mean age 9y 5mo [SD 11mo]; 31 females, mean age 9y 6mo [1y 2mo]) and 100 children with CP who drooled (57 males, mean age 9y 5mo [3y 11mo], range 3-19y; 43 females, mean age 10y 1mo [4y 9mo], range 4-19y), of whom 53 had spastic, 42 had dyskinetic, and five had ataxic CP. Almost all children were affected bilaterally, and 90 of them were at Gross Motor Function Classification System levels III or higher.

Efficacy of diagnostic upper node evaluation during (salvage) laryngectomy for supraglottic carcinoma.

Background: The effectiveness of selective upper node dissection or inspection during laryngectomy for supraglottic squamous cell carcinoma was evaluated. These diagnostic procedures aimed to cause less morbidity than elective neck dissection in patients with a clinically N0 neck.

Methods: In 93 patients, 166 clinically N0 necks (73 bilateral and 20 contralateral) were evaluated.

Efficacy of diagnostic upper-node procedures during laryngectomy for glottic carcinoma.

Background: Regional recurrence of glottic squamous cell carcinoma was evaluated in patients with a clinically N0 neck who underwent selective upper-node dissection (SUND) or selective upper-node inspection (SUNI; surgical visualization and palpation of jugular lymph nodes at levels II and III) during (salvage) laryngectomy.

Methods: In 152 patients, 291 clinically N0 (139 bilateral and 13 contralateral) necks were evaluated for occult neck metastases by SUNI or SUND during (salvage) laryngectomy.

Results: Occult neck metastases were identified with SUNI or SUND in 7% of the necks (21 of 291).