Effectiveness and safety of botulinum toxin in comparison with surgery for drooling in paediatric patients with neurological disorders: a systematic review.

Different therapeutic methods for chronic drooling in paediatric patients with neurological problems have been described in the scientific literature. However, there is no consensus on the ideal strategy of treatment. The aim of this study was to compare botulinum toxin injection therapy and surgical modalities to control drooling in paediatric patients with neurological disorders. A systematic literature search was conducted on nine electronic databases for publications until April 2020. Six articles were included with a total sample of 209 patients, 67.4% (n = 141) of whom had cerebral palsy. All studies used injections of botulinum toxin type A with application to the submandibular and/or parotid salivary glands. The surgical treatments were duct ligation in the parotid and/or submandibular salivary glands, duct relocation in the submandibular salivary glands, and glandular excision of the submandibular and sublingual salivary glands. There were complications in only 16.1% (n = 27) of the sample (11 cases due to botulinum toxin application and 16 due to surgery). Drooling control was assessed by objective and subjective measures. Although surgical procedures presented a higher risk of adverse effects than botulinum toxin type A in all the studies and measurements performed, they presented larger and longer-lasting positive effects on drooling. We suggest bilateral submandibular duct relocation with bilateral sublingual gland excision or isolated bilateral submandibular duct ligation, which were the surgical techniques with the largest samples in this review. Nevertheless, further studies are necessary to compare samples with botulinum toxin type A and surgical treatment.

Dosagem hormonal e avaliação testicular em cachorro-do-mato (Cerdocyun thous) utilizando diferentes protocolos anestésicos / Hormonal analyses and testicular evaluation in Cerdocyun thous using different anesthetic protocols

Tree Cerdocyon thous males received different anesthesia protocols: tiletamine-zolazepan (7mg/kg); ketamine-xylazine (12 and 1mg/kg); ketamine-xylazine-atropin (12, 1.0 and 0.04mg/kg), ketamine-midazolam (12 and 0.5mg/kg) and ketamine-acepromazine (12 and 0.1mg/kg) for semen collection by electroejaculation, testosterone hormonal dosages, fine needle aspiration cytology (FNAC), testicular manual evaluation, biometry by caliper and ultrassonography (US). The ejaculates collected by electroejaculation showed urine contamination making impossible the semen evaluation. The M±PD of serum testosterone was 0.74±0.2ng/mL. The cell types found in FNAC were: spermatogonia 13.3±11.5 percent, primary spermatocytes 5.5±1.1 percent, secondary spermatocytes 5.5±3.9 percent, early spermatids 12.8±6.2 percent, late spermatids 26.2±11.2 percent, sperm 14.5±4.7 percent and Sertoli cells 21.8±2.7 percent. Manual testicular evaluation showed normal consistency of testicles. The M±PD of testicular biometry by caliper was 3.8±1.5cm³ and by US was 1.1±0.3cm³. The animals showed normal spermatogenesis with normal spermatozoa observed in FNAC and normal testicular US.