gms | German Medical Science

Introduction: Drooling is a common problem among children especially in those with neurologic impairment from cerebral palsy. It can affect the quality of life of both patients and their parents due to social isolation. Bilateral submandibular duct relocation is one of the surgical treatment options used to control drooling.The aim of this study was to investigate the efficacy and safety of surgical bilateral submandibular duct relocation in children suffering from excessive drooling.

Materials/methods: Seven patients, 4 male and 3 female, age 2,5–15 years (mean 5,6 years) underwent submandibular duct relocation in a period of five years. Six children had Down’s syndrome and one suffered from micrognathy of maxilla. Mean follow-up was 21 months (range 12–30 months). Inclusion criterion was residual drooling after the failure of 6 months of oral-motor physiotherapy. Treatment with botox injection was not accepted as treatment option by the parents in all cases. The severity of drooling and the success of surgery were evaluated by the parents by means of two grading scales, before and one year after surgery respectively.

Results: The severity of drooling was graded as excessive in 3 cases severe in another 3 cases and moderate in 1 case. Satisfactory reduction of sialorroea was achieved in all patients with four graded as excellent and three as good by the parents 1 year later. No major complications were recorded in all cases. A minor complication occurred in one case as a transient sublimandibular sialadenitis in the early postoperative period.

Conclusion: Submandibular duct relocation is a safe and effective procedure in controlling drooling when conservative treatment fails and botox injection is not accepted by the parents as a treatment option.