Management of drooling for patients in the north of Iran: analysis of the surgical management

Abstract

• BACKGROUND: Drooling is a common problem in children and adults with neuromuscular disorders. This problem is best dealt with using a multidisciplinary team approach. The objective of this paper is to assess the results following surgery at the Drooling Clinic of Amiralmomenin Hospital.
• METHODS: The results of the surgical protocol used between 1994 and 2007 at the Drooling Clinic of Amiralmomenin Hospital in Rasht, Iran, reported thirty-two patients underwent submandibular duct relocation and sublingual resection. The preoperative and postoperative levels of drooling were measured. The parents of the patients were contacted by telephone at least one year after operation.
• RESULTS: Of all the patients, eighteen were male and fourteen were female and were aged 6 years to 26 years. Of 30 patients with complete patients' chart, the mean drooling score fell from 7.59 to 2.71 after surgery (p < 0.0001). In 30 patients, results of operation were ascertained by telephone at average of 5.6 years after operation. In 78.1% of patients, long-term result was successful and none were considered worse after the procedure. There were few complications, none of which had any long-term adverse effects. Swelling of submandibular glands was frequently observed in the immediate post-operative period. Only one ranula was seen as delayed complication.
• CONCLUSIONS: Submandibular duct relocation with simultaneous sublingual gland excision is a safe and consistently efficient procedure for the treatment of chronic sialorrhea. It is believed that this operation is more physiological procedure than others.
• KEYWORDS: Drooling, Sialorrhea, Submandibular Relocation, Salivary Glands.