PS09 CONTEMPORARY SURGICAL MANAGEMENT OF SILALORRHEA

Abstract

Peristsent sialorrhea (drooling) is often a problem in cerebral palsy, mental retardation and neurological conditions. Management modalities have included behavioural and postural modifications, pharmacotherapy, radiotherapy and surgery. Early surgical treatments were removal of glands, duct ligations and neurectomies. The newest and most conservative operation is relocation of submandibular ducts to the tongue base and removal of sublingual glands. In a personal series of 16 cases 11 were children.Purpose To review the indications and results of submandibular duct relocations (with sublingual gland removal) in 11 children with uncontrolled sialorrhea.Methodology Review of hospital and outpatient records, and illustration of the operative technique on a video. Anatomical variations can be encountered.Results The median hospital stay was 2 days. There were no significant complications. Caregivers judged the efficacy with a median score of “75%”.Conclusion Duct relocation with sublingual gland removal is a safe and reliable technique for sialorrhea, with very good control in most cases. In contrast to botulinum toxin treatment its effects are permanent.