Bilateral submandibular duct relocation for drooling: an evaluation of results for the Birmingham Children's Hospital

• Published in: European archives of oto-rhino-laryngology 2003, Vol.260 (1), p.48-51
• Main Authors: UPPAL, Harpreet S, DE, Ranit, D'SOUZA, Alwyn R, PEARMAN, Ken, PROOPS, David W
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Female; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Hospitalization; Hospitals, Pediatric; Humans; Male; Medical sciences; Non tumoral diseases; Otorhinolaryngology. Stomatology; Retrospective Studies; Severity of Illness Index; Sialorrhea - diagnosis; Sialorrhea - physiopathology; Submandibular Gland - physiopathology; Submandibular Gland - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Surgical Procedures, Operative - methods; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-002-0516-4

Drooling is a problem of the neurologically impaired that often leads to stigmatisation and social isolation. Bilateral submandibular duct relocation (BSMDR) is a surgical procedure that may be used to control troublesome drooling. The aim of this study was to assess the results following surgery and attempt to identify those factors that would mitigate against a successful outcome. A retrospective case note review was performed, and data were collected on 23 neurologically impaired patients who underwent the procedure between 1993 and 2000 at the Birmingham Children's Hospital, UK. An overall improvement in drooling was demonstrated in 20 (87%) cases, with complete cessation of drooling in 13 (57%) cases. The complications included one ranula, three transient submandibular gland swellings and two persistent swellings requiring gland excision. It is difficult to predict which patients will have an unsuccessful outcome following surgery. In our series, three (13%) patients had poor results. We could not determine any special features that could account for this, except that these patients in particular demonstrated the greatest degree of oral-motor dysfunction. BSMDR is a technically straightforward procedure associated with minimal morbidity and a high success rate. It is the procedure of choice at our institution.