Which surgery for drooling in patients with cerebral palsy?

J Pediatr Surg. 2013 Oct;48(10):2171-4. doi: 10.1016/j.jpedsurg.2013.06.017.

Abstract

Background: Surgery for drooling in patients with cerebral palsy should not produce xerostomia in order not to deteriorate speech, taste, or the status of oral hygiene. It must be a compromise between drooling and quality of life. The purpose of the present report is to describe our surgical strategy that respects the above principles.

Materials and methods: Patients were initially operated on depending on the drooling severity. The results were evaluated according to the frequency of residual drooling and the Thomas-Stonel and Greenberg classification. Quantitative assessment was proposed 6 months after surgery. The data have been compared using the nonparametric Wilcoxon matched-pairs test.

Results: Thirty-five patients underwent surgery between 1991 and 2012. Owing to incomplete data, only 31 patients could be included, aged 5 to 24 years (mean: 12 years). All patients underwent surgery on the submandibular duct. Only 16 patients underwent a simultaneous surgery on the parotid duct. Six patients were reoperated: 3 because of an insufficient result and 3 because of a surgical complication. Changes/Day ranged from 1 to 7 (median: 3) before surgery and 0 to 2 (median: 1) after surgery (p < 0.01). Number of bibs/day ranged from 0 to 30 (median: 4) before surgery and 0 to 4 (median: 1) after surgery (p < 0.01). No dental deterioration and no caries occurred after surgery.

Conclusion: Good results for drooling can be obtained with a simple surgical procedure on the submandibular ducts, maintaining quality of life, avoiding deterioration of speech, taste, and the status of oral hygiene.

Keywords: Cerebral palsy; Children; Surgery for drooling.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Cerebral Palsy / complications*
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Parotid Gland / surgery*
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Sialorrhea / etiology
  • Sialorrhea / surgery*
  • Submandibular Gland / surgery*
  • Treatment Outcome
  • Young Adult