Humans ; Sialorrhea ; etiology ; therapy

The tongue is located inside the oral cavity at rest, and the structural interrelations between the tongue and the oral cavity is essentially important for normal tongue function. Macroglossia is clinically diagnosed whenever the tongue does not fit the oral cavity, thus patients complain of noisy breathing, drooling, speech and swallowing dysfunction, malocclusion, and social ridicule. Partial glossectomy for macroglossia volume has been assumed to be difficult. In this study, we attempted to measure the tongue volume with the plaster tongue model in a 7-year-old macroglossia patient. This method is reliable and simple for measuring the tongue volume in macroglossia.
Child ; Deglutition ; Glossectomy* ; Humans ; Macroglossia* ; Malocclusion ; Mouth ; Respiration ; Sialorrhea ; Tongue*

Clozapine has been demonstrated to be useful for treating refractory schizophrenia. However, hypersalivation occurs in 31.0-97.4% of the patients treated with clozapine. Accordingly, some patients who are disturbed by their hypersalivation refuse to continue with clozapine treatment. This study investigated the efficacy of the anticholinergic agent scopolamine butylbromide against clozapine-induced hypersalivation. Five schizophrenia patients were coadministered scopolamine butylbromide (30-60 mg/day) for 4 weeks. At the baseline and after 4 weeks' treatment, we subjectively evaluated hypersalivation using a visual analog scale and objectively assessed it using the Drooling Severity Scale and Drooling Frequency Scale. As a result, improvements in the patients' Drooling Severity Scale and Drooling Frequency Scale scores, but no improvements in their visual analog scale scores, were observed after scopolamine butylbromide treatment. These results indicate that at least some schizophrenic patients with clozapine-induced hypersalivation would benefit from scopolamine butylbromide treatment. We conclude that clozapine-induced hypersalivation is one factor of stress to patients. Subjective hypersalivation was not improved, but objective hypersalivation was, by scopolamine butylbromide treatment. However, scopolamine butylbromide and clozapine possess anticholinergic effects so clinicians should closely monitor patients who take scopolamine butylbromide.
Clozapine ; Humans ; Schizophrenia ; Scopolamine Hydrobromide* ; Sialorrhea* ; Visual Analog Scale

Authors experienced aspiration pneumonia during clozapine therapy in a 31 year-old woman patient with treatment-resistant schizophrenia. Development of aspiration pneumonia appeared to be related with side effects of clozapine including sedation, sialorrhea, and esophageal dysfunction. Each side effect seems to be mild, however it can cause fatal problems such as aspiration pneumonia if they appear simultaneously.
Adult ; Clozapine* ; Female ; Humans ; Pneumonia, Aspiration* ; Schizophrenia ; Sialorrhea

BACKGROUND: Because there are numerous methods for reconstruction of the lower lip, it is not easy to choose the optimal method. In choosing the surgical method for lower lip reconstruction, we obtained acceptable outcomes based on our treatment strategy, which included either a barrel-shaped excision or the Webster modification of the Bernard operation. We report on the surgical outcomes based on our treatment strategy. METHODS: This study included 26 patients who underwent lower lip reconstructive surgery from September 1996 to September 2010. The operation was done using either a barrel-shaped excision or the Webster modification, considering the location of the defect, the size of the defect, and the amount of residual tissue on the lateral side of the vermilion after excision. RESULTS: In our series, 3 patients underwent a single barrel-shaped excision, and nine patients underwent a double barrel-shaped excision. In addition, the unilateral Webster modification was performed on in 6 patients, and there were eight cases of bilateral Webster modification. All of the patients except one were satisfied with the postoperative shape of the lip. In one case both recurrence and dehiscence occurred. One patient had a good postoperative lip shape, but had difficulty wearing a denture, and also underwent commissuroplasty. Furthermore, there were two patients who complained of drooling, and 4 with paresthesia. CONCLUSIONS: A soft tissue defect resulting from wide excision of a lower lip malignancy can be successfully reconstructed using only one of two surgical methods: the barrel-shaped excision or the Webster modification of the Bernard operation.
Dentures ; Facial Neoplasms ; Humans ; Lip ; Reconstructive Surgical Procedures ; Recurrence ; Sialorrhea

OBJECTIVE: To investigate the clinical usefulness of the transdermal scopolamine patch applied to control drooling of saliva in patients with cerebral palsy. METHOD: We enrolled twenty two patients with cerebral palsy residing in a rehabilitation center. The mean age of the patients was 24.0 years old. Transdermal scopolamine patch was applied to the patients for 2 weeks. We measured drooling quantity, severity of drooling, and visual analog scale of care givers' labor intensity at pre-application, post 1 week, and post 2 weeks. RESULTS: Drooling quantity decreased significantly from 4.1+/-1.9 ml to 2.8+/-1.5 ml at post 1 week (p<0.01), and 2.2+/-1.6 ml at post 2 weeks (p<0.01). Severity of drooling decreased from 4.1+/-0.8 to 2.9+/-1.1 at post 2 weeks (p<0.01). Visual analog scale of care givers' labor intensity decreased from 78.2+/-17.4 (mm) to 52.7+/-18.6 at post 1 week (p<0.01), and 45.9+/-22.8 at post 2 weeks (p<0.01). CONCLUSION: These findings suggested that the transdermal scopolamine patch is effective to reduce the drooling of saliva in patients with cerebral palsy within short term.
Cerebral Palsy ; Humans ; Rehabilitation Centers ; Saliva ; Scopolamine Hydrobromide ; Sialorrhea

BACKGROUND: Hypersalivation can be a troublesome side effect of clozapine, limiting its usefulness in the management some cases of schizophrenia. But the pharmacodynamic basis of clozapine-induced hypersalivation remains obscure. Object : The aim of this study was to evaluate the effect of the alpha2-adrenergic agonist clonidine on clozapin-induced hypersalivation in the patients who were receiving clozapine. METHOD: Twenty one schizophrenic inpatients on clozapine participated in the study. The amount of saliva was measur on the 7th day at 8pm after starting clozapine treatment. Of them, 15 patients who had experienced hypersalivation treated with 0.1mg/day of clonidine. RESULT: Of 21 schizophrenic patients treated with clozapine in the psychiatric inpatients clinic, 15(71.4%) complain hypervalivation. After clonidine treatment, mean salivary flow-rate was decreased significantly in these patients. CONCLUSION: Clozapine-induced hypersalivation could be decreased by administration of alpha2-adrenergic agonist clonidine are compliance could be improved. Also our study supports the notion that increased adrenergic tone contributes to clozapine induce hypersalivation.
Clonidine* ; Clozapine ; Compliance ; Humans ; Inpatients ; Saliva ; Schizophrenia ; Sialorrhea*

OBJECTIVE: To study the effect of functional chewing training (FuCT) on masticatory function, the severity of tongue thrust, and the severity and frequency of drooling in children with cerebral palsy. METHODS: A prospective study was performed for 48 children who were diagnosed with oral motor dysfunction from January 2019 to January 2020, and they were randomly divided into an FuCT group and an oral motor training group, with 24 children in each group. Both groups received FuCT or oral motor training for 12 weeks, and then they were evaluated in terms of the changes in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling. RESULTS: There were no significant differences between the two groups in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling before treatment (P>0.05). After the 12-week training, the FuCT group showed significant improvements in the masticatory function and the severity of tongue thrust and drooling (P<0.05), but with no improvement in the frequency of drooling (P>0.05), while the oral motor training group had no improvements in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling (P>0.05). After the 12-week training, the FuCT group had more significantly improvements in the severity of tongue thrust and the severity and frequency of drooling than the oral motor training group (P<0.05). CONCLUSIONS FuCT can effectively improve the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling in children with cerebral palsy.
Cerebral Palsy ; Child ; Humans ; Mastication ; Prospective Studies ; Sialorrhea

OBJECTIVE: To investigate Botulinum toxin type B (BNT-B) injection's effect and duration depending on dose for patients with brain lesion. METHOD: Twenty one patients with brain lesion and severe drooling were included and divided into three groups. All patients received conventional dysphagia therapy. Group A patients (n=7) received an injection of 1,500 units and group B patients (n=7) received an injection of 2,500 units of BNT-B in submandibular gland under ultrasound guidance. Group C patients (n=7) received conventional dysphagia therapy. Saliva secretion was assessed quantitatively at baseline and at weeks 1, 2, 4, 8, and 12. The severity and frequency of drooling was assessed using the Drooling Quotient (DQ) by patients and/or caregivers. RESULTS: Group A and B reported a distinct improvement of the symptoms within 2 weeks after BNT-B injection. Compared to the baseline, the mean amount of saliva decreased significantly throughout the study. However, there was no meaningful difference between the two groups. The greatest reductions were achieved at 2 weeks and lasted up to 8 weeks after BNT-B injection. Group C did not show any differences. CONCLUSION: Local injection of 1,500 units of BNT-B into salivary glands under ultrasonic guidance proved to be a safe and effective dose for drooling in patient with brain lesion, as did 2,500 units.
Botulinum Toxins ; Brain ; Deglutition Disorders ; Humans ; Saliva ; Salivary Glands ; Sialorrhea ; Submandibular Gland ; Ultrasonics

Tachycardia rarely consists of an ictal symptomatology associated with autonomic symptoms such as sialorrhea, even if it commonly precedes or combines with a limbic aura of complex partial seizure. A 14-year-old boy with recurrent palpitation, chest discomfort, and sialorrhea suffered from a pure autonomic seizure presenting as sinus tachycardia with a neural origin, which had been misdiagnosed as paroxysmal supraventricular tachycardia without improvement by cardiac medication. The right mesial temporal origin was revealed by video CCTV-EEG with the profile of the heart rate during ictus.
Adolescent ; Epilepsy ; Heart Rate ; Humans ; Male ; Seizures* ; Sialorrhea ; Tachycardia ; Tachycardia, Sinus* ; Tachycardia, Supraventricular ; Temporal Lobe ; Thorax