Submandibular duct orifices relocation as a drooling treatment in a 14 years old
patient A case report and review of the literature
Savvas TITSINIDES, George MARKOPOULOS, Nadia THEOLOGIE-LYGIDAKIS, Ioannis IATROU
Department of Oral and Maxillofacial Surgery at the Children’s Hospital “P. and A. Kyriakou”, Dental School, University of Athens, Greece (Head: Professor I. Iatrou)
Hellenic Archives of Oral & Maxillofacial Surgery (2014) 3, 133-139
SUMMARY: Excessive drooling noticed in patients with cerebral palsy is an unpleasant situation, especially in the case of children. For a successful outcome a thorough assessment of its severity and selection of the proper therapeutic modality is demanding. Treatment concerning either reduction of produced saliva or repositioning of salivary duct orifices is accomplished via conservative, invasive or alternative methods. A case of a 14 years old female patient with cerebral palsy, mild mental retardation and intense drooling is presented. Therapeutically, surgical repositioning of submandibular ducts orifices posteriorly at the floor of the mouth was selected. Clinically, drooling was reduced, relieving this young patient from one of her daily severe problems.
KEY WORDS: Drooling, relocation of submandibular duct orifices
REFERENCES
Blasco PA, Stansbury JC: Glycopyrrolate treatment of chronic drooling. Arch Pediatr Adolesc Med. 150(9):932-5, 1996
Brei TJ: Management of drooling. Semin Ped Neurol. 10(4):265-270, 2003
Burton MJ, Leighton SEJ, Lund WS: Long-term results of submandibular duct transposition for drooling. J Laryngol Otol.105:101-103, 1991
Cotton RA, Richardson MA: The effect of submandibular duct rerouting in the treatment of sialorrhea in children. Otolaryngol Head Neck Surg . 89:535-541, 1981
Crysdale WS: Management options for the drooling patients. Ear Nose Throat J. 68:820-830, 1989
Crysdale WS: Drooling. Experience with team assessment and management. Clin Pe diatr. 31:77-80, 1992
Crysdale WS, Raveh E, McCann C, Roske L, Kotler A: Management of drooling in individuals with neurodisability: a surgical experience. Dev Med Child Neurol. 43:379-383, 2001
Crysdale WS, McCann C, Roske L, Joseph M, Semenuk D, Chait P: Saliva control issues in the neurologically challenged. A 30 year experience in team management. Int J Ped Otorhinolaryngol. 70(3):519-527, 2006
Crysdale WS, White A.: Submandibular duct relocation for drooling: a 10-year experience with 194 patients. Otolaryngol Head Neck Surg. 101(1):87–92, 1989 Ernster JA: Surgical reduction of salivary flow in children with spastic disorders. Oper Tech Otolaryngol-Head Neck Surg. 11(3):206- 209, 2000
Goode RL, Smith RA: The surgical management of sialorrhea. Laryngoscope. 80:1078-1088, 1970
Greensmith AL, Johnstone BR, Reid SM, Hazard CJ, Johnson HM, Reddihough DS: Prospective analysis of the outcome of surgical management of drooling in the pediatric population: A 10-year experience. Plast Reconstr Surg. 116:1233-1242, 2005
Guerin RL: Surgical management of drooling. Arch Otolaryngol. 105:535-537, 1979
Kim H, Lee Y, Weiner D, Kaye R, Cahill AM, Yudkoff M: Botulinum toxin type A injections to salivary glands: combination with single event multilevel chemoneurolysis in 2 children with severe spastic quadriplegic cerebral palsy. Arch Phys Med Rehabil. 87:141-144, 2006
Lespargot A, Langevin M, Muller S, Guillemont S: Swallowing disturbances associated with drooling in cerebral palsied children. Dev Med Child Neurol. 35: 298–304, 1993
Lev R, Clark RF: Neuroleptic malignant syndrome presenting without fever, case report and review of the literature. J Emerg Med. 12:49-55, 1994
Lewis DW, Fontana C, Mehallick LK, Everett Y: Transdermal scopolamine for reduction of drooling in developmentally delayed children. Dev Med Child Neurol. 36(6):484-6, 1994
Liptak GS: Complementary and alternative therapies for cerebral palsy. Mental Retard Devel Dis Res Rev. 11:156-163, 2005
Lloyd RV, Tranter RM, Moffat V, Green E: Review of management of drooling problems in neurologically impaired children: a review of methods and results over 6 years at Chailey Heritage Clinical Services. Clin Otolaryngol. 26:76-81, 2001
Mankarious LA, Bottrill ID, Huchzermeyer PM, Bailey CM: Long-term follow-up of submandibular duct rerouting for the treatment of sialorrhea in the paediatric population. Otolaryngol Head Neck Surg. 120:303-307, 1999
Meningaud JP, Pitac-Arnnop P, Chikhani L, Bertrand JC: Drooling of saliva: A review of the etiology and management options. Oral Surg Med Pathol Radiol Endod. 101:48-57, 2006
Nunn JH: Drooling: review of the literature and proposals for management. J Oral Rehabil. 27:735-743, 2000
O’Dwyer TP, Timon C, Walsh MA: Surgical management of drooling in the neurologically damaged child. J Laryngol Otol. 103:750-752, 1989
O’Dwyer TP, Conlon BJ: The surgical management of drooling – a 15 year follow-up. Clin Otolaryngol. 22:284-287, 1997
Ozgenel GY, Ozcan M, Kahveci Z: An experimental study of bilateral repositioning of the Stensen’s duct orifices with autologous vein and artery grafts in dogs. Br J Plast Surg. 53:106-108, 2000
Panarese A, Ghosh S, Hodgson D, McEwan J, Bull PD: Outcomes of submandibular duct re-implantation for sialorrhoea. Clin Otolaryngol. 26:143-146, 2001 Strauss M., Nageris B., Shvili Ytzh., Feinmesser R.: The surgical management of drooling. Oper Tech Otolaryngol-Head Neck Surg. 7(4):311-14, 1996
Uppal HS, De R, D’Souza AR, Pearman K, Proops DW: Bilateral submandibular duct relocation for drooling:an evaluation of results for the Birmingham Children’s Hospital. Eur Arch Otorhinolaryngol. 260:48-51, 2003
Wilson SW, Henderson HP: The surgical treatment of drooling in Leicester: 12 years experience. Br J Plast Surg. 52: 335-338, 1999
Yam WKL, Yang HLCh, Abdullah V, Chan CYL: Management of drooling for children with neurological problems in Hong Kong. Brain & Develop. 28:24-29, 2006
Department of Oral and Maxillofacial Surgery at the Children’s Hospital “P. and A. Kyriakou”, Dental School, University of Athens, Greece (Head: Professor I. Iatrou)
Hellenic Archives of Oral & Maxillofacial Surgery (2014) 3, 133-139
SUMMARY: Excessive drooling noticed in patients with cerebral palsy is an unpleasant situation, especially in the case of children. For a successful outcome a thorough assessment of its severity and selection of the proper therapeutic modality is demanding. Treatment concerning either reduction of produced saliva or repositioning of salivary duct orifices is accomplished via conservative, invasive or alternative methods. A case of a 14 years old female patient with cerebral palsy, mild mental retardation and intense drooling is presented. Therapeutically, surgical repositioning of submandibular ducts orifices posteriorly at the floor of the mouth was selected. Clinically, drooling was reduced, relieving this young patient from one of her daily severe problems.
KEY WORDS: Drooling, relocation of submandibular duct orifices
REFERENCES
Blasco PA, Stansbury JC: Glycopyrrolate treatment of chronic drooling. Arch Pediatr Adolesc Med. 150(9):932-5, 1996
Brei TJ: Management of drooling. Semin Ped Neurol. 10(4):265-270, 2003
Burton MJ, Leighton SEJ, Lund WS: Long-term results of submandibular duct transposition for drooling. J Laryngol Otol.105:101-103, 1991
Cotton RA, Richardson MA: The effect of submandibular duct rerouting in the treatment of sialorrhea in children. Otolaryngol Head Neck Surg . 89:535-541, 1981
Crysdale WS: Management options for the drooling patients. Ear Nose Throat J. 68:820-830, 1989
Crysdale WS: Drooling. Experience with team assessment and management. Clin Pe diatr. 31:77-80, 1992
Crysdale WS, Raveh E, McCann C, Roske L, Kotler A: Management of drooling in individuals with neurodisability: a surgical experience. Dev Med Child Neurol. 43:379-383, 2001
Crysdale WS, McCann C, Roske L, Joseph M, Semenuk D, Chait P: Saliva control issues in the neurologically challenged. A 30 year experience in team management. Int J Ped Otorhinolaryngol. 70(3):519-527, 2006
Crysdale WS, White A.: Submandibular duct relocation for drooling: a 10-year experience with 194 patients. Otolaryngol Head Neck Surg. 101(1):87–92, 1989 Ernster JA: Surgical reduction of salivary flow in children with spastic disorders. Oper Tech Otolaryngol-Head Neck Surg. 11(3):206- 209, 2000
Goode RL, Smith RA: The surgical management of sialorrhea. Laryngoscope. 80:1078-1088, 1970
Greensmith AL, Johnstone BR, Reid SM, Hazard CJ, Johnson HM, Reddihough DS: Prospective analysis of the outcome of surgical management of drooling in the pediatric population: A 10-year experience. Plast Reconstr Surg. 116:1233-1242, 2005
Guerin RL: Surgical management of drooling. Arch Otolaryngol. 105:535-537, 1979
Kim H, Lee Y, Weiner D, Kaye R, Cahill AM, Yudkoff M: Botulinum toxin type A injections to salivary glands: combination with single event multilevel chemoneurolysis in 2 children with severe spastic quadriplegic cerebral palsy. Arch Phys Med Rehabil. 87:141-144, 2006
Lespargot A, Langevin M, Muller S, Guillemont S: Swallowing disturbances associated with drooling in cerebral palsied children. Dev Med Child Neurol. 35: 298–304, 1993
Lev R, Clark RF: Neuroleptic malignant syndrome presenting without fever, case report and review of the literature. J Emerg Med. 12:49-55, 1994
Lewis DW, Fontana C, Mehallick LK, Everett Y: Transdermal scopolamine for reduction of drooling in developmentally delayed children. Dev Med Child Neurol. 36(6):484-6, 1994
Liptak GS: Complementary and alternative therapies for cerebral palsy. Mental Retard Devel Dis Res Rev. 11:156-163, 2005
Lloyd RV, Tranter RM, Moffat V, Green E: Review of management of drooling problems in neurologically impaired children: a review of methods and results over 6 years at Chailey Heritage Clinical Services. Clin Otolaryngol. 26:76-81, 2001
Mankarious LA, Bottrill ID, Huchzermeyer PM, Bailey CM: Long-term follow-up of submandibular duct rerouting for the treatment of sialorrhea in the paediatric population. Otolaryngol Head Neck Surg. 120:303-307, 1999
Meningaud JP, Pitac-Arnnop P, Chikhani L, Bertrand JC: Drooling of saliva: A review of the etiology and management options. Oral Surg Med Pathol Radiol Endod. 101:48-57, 2006
Nunn JH: Drooling: review of the literature and proposals for management. J Oral Rehabil. 27:735-743, 2000
O’Dwyer TP, Timon C, Walsh MA: Surgical management of drooling in the neurologically damaged child. J Laryngol Otol. 103:750-752, 1989
O’Dwyer TP, Conlon BJ: The surgical management of drooling – a 15 year follow-up. Clin Otolaryngol. 22:284-287, 1997
Ozgenel GY, Ozcan M, Kahveci Z: An experimental study of bilateral repositioning of the Stensen’s duct orifices with autologous vein and artery grafts in dogs. Br J Plast Surg. 53:106-108, 2000
Panarese A, Ghosh S, Hodgson D, McEwan J, Bull PD: Outcomes of submandibular duct re-implantation for sialorrhoea. Clin Otolaryngol. 26:143-146, 2001 Strauss M., Nageris B., Shvili Ytzh., Feinmesser R.: The surgical management of drooling. Oper Tech Otolaryngol-Head Neck Surg. 7(4):311-14, 1996
Uppal HS, De R, D’Souza AR, Pearman K, Proops DW: Bilateral submandibular duct relocation for drooling:an evaluation of results for the Birmingham Children’s Hospital. Eur Arch Otorhinolaryngol. 260:48-51, 2003
Wilson SW, Henderson HP: The surgical treatment of drooling in Leicester: 12 years experience. Br J Plast Surg. 52: 335-338, 1999
Yam WKL, Yang HLCh, Abdullah V, Chan CYL: Management of drooling for children with neurological problems in Hong Kong. Brain & Develop. 28:24-29, 2006
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