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General
Published in Mijna Hadders-Algra, Kirsten R. Heineman, The Infant Motor Profile, 2021
Mijna Hadders-Algra, Kirsten R. Heineman
Drooling is the clearly visible spilling of saliva from the mouth (McInerney et al. 2019). Typically developing infants may show some drooling when they explore an object with their mouths. Drooling is included in the domain of variation as marked drooling reflects the presence of stereotyped orofacial movements.
Common paediatric ENT viva topics
Published in Joseph Manjaly, Peter Kullar, Advanced ENT Training, 2019
Benjamin Hartley, Richard J Hewitt
Drooling is the unintentional loss of saliva from the mouth. It is a normal phenomenon in many children prior to the development of oral neuromuscular control at age 18–24 months but considered abnormal if it persists beyond the age of 4 years. Drooling may be caused by overproduction of saliva (rare, except for when teething) or decreased clearance (common). The most likely aetiology to require active management is the lack of neuromuscular coordination (20%–30% of children with cerebral palsy have problematic drooling). These children have a poor swallowing reflex with reduced oromotor and lingual control. Your history and examination should aim to elucidate the aetiology and severity of the condition with these differentials in mind.
Non-Neoplastic Salivary Gland Diseases
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Stephen R. Porter, Stefano Fedele, Valeria Mercadante
Drooling is the unintentional loss of saliva from the mouth,284 common in normally developed babies but considered abnormal after age 4.285 Drooling may arise as a consequence of impaired neuromuscular function, though less frequently it can be due to an increased production of saliva (idiopathic or drug-induced). In children, the most common cause of drooling is cerebral palsy, which persists in 37–58% of these individuals.286, 287 In adults, drooling can be observed in 45% of patients affected by Parkinson’s disease.288 Neurological disorders also associated with drooling are cerebral palsy, amyotrophic lateral sclerosis and facial palsy.289
Understanding and managing respiratory infections in children and young adults with neurological impairment
Published in Expert Review of Respiratory Medicine, 2023
Marijke Proesmans, Francois Vermeulen, Mieke Boon
Drooling and/or hypersalivation is a common problem in the NI patient population and is related to ineffective swallowing. While anterior drooling may not be associated with increased risk of aspiration (although it could also indicate ineffective swallowing?), posterior drooling may carry a higher risk for aspiration but it is more difficult to assess. Drooling may be decreased by medication such as glycopyrrolate [24]. Although relatively safe, main side effects are constipation, dry mouth or thickened secretions (which may lead to mucus plugging) and urinary retention. Moreover, it has a short half life time and thus should be given several times a day [25]. Scopolamine transdermal patches have a longer half-life and are an alternative to diminish the severity of drooling. Again, studies on their effectiveness in the population discussed here is limited. In a retrospective study in 44 children with non-progressive neurodevelopmental disability scopolamine patches significantly decreased drooling as well as drooling related complaints such as choking [26].
Obstructive sleep apnea: personalizing CPAP alternative therapies to individual physiology
Published in Expert Review of Respiratory Medicine, 2022
Brandon Nokes, Jessica Cooper, Michelle Cao
The dose–response relationship between dental device advancement and AHI reduction is highly variable [83]. Less severe OSA is more likely to achieve treatment success with MAD. The degree of success is related to the degree of mandibular advancement and thereby the widening of the retropalatal airspace through stiffening of the lateral pharyngeal walls [84]. The mandible should be advanced past the point of centric occlusion (teeth occlusion position when the mandibular condyle is in the most anterior/superior position within the glenoid fossa) in order to have treatment success [85]. Typically, the process of improving OSA through MAD takes several months for device molding and steady adjustments as patients become used to it. Thus, many clinicians opt to use a boil and bite MAD as a trial of tolerability before embarking on custom MAD placement. Common side effects are drooling and mouth dryness. The drooling tends to abate over the first few weeks, whereas mouth dryness can persist [82]. Elevated age, BMI, ‘pinched’ expiratory flow limitation, as well as ‘deeper’ desaturation events, are all associated with lack of treatment response to MAD [86].
Swallowing-related quality of life among oral-feeding Chinese patients with Parkinson’s disease – a preliminary study using Chinese SWAL-QOL
Published in Disability and Rehabilitation, 2022
Hiu Fung Chan, Manwa Lawrence Ng, HyangHee Kim, Deog Young Kim
As for the dysphagia symptoms reported in the DSB, several patient-reported symptoms were highly prevalent among the PD participants, such as drooling, coughing and having excess saliva or phlegm. In this study, participants scored the lowest mean value for drooling (mean = 72.76), suggesting that drooling is the most frequent dysphagic symptom in PD. Drooling, known as “sialorrhea”, refers to the inability to control oral secretions, leading to excessive saliva in the oropharynx [6]. Studies [31,32] reported that over 70% of PD patients suffer from drooling or wetting of pillow during sleeping. Chou et al. [6] pointed out that drooling in PD is more likely to be caused by flexed head posture and infrequent or impaired swallowing. Having excessive saliva or phlegm in the mouth may become a source of aspiration, leading to choking and pneumonia [6]. The present findings emphasize the need for clinicians to work closely in the treatment of drooling in PD patients, in order to prevent aspiration pneumonia.