Evaluation and management of the drooling patient

Drooling, or sialorrhea, may appear to be a most mundane problem but in fact can be a condition with a wide spectrum of etiologies. Unhappily, drooling also may lead to several unfortunate medical and psychosocial outcomes for the affected patient. The senior author (WSC) has had a 13 year interest in the treatment of drooling patients. This paper is essentially a distillation of the experience gained in managing these patients. Since 1979 he has participated in a team (which includes an otolaryngologist, a dentist and a speech pathologist) that attends these patients and makes recommendations in a consensus fashion. This team concept, as well as historical and physiologic background material, will be discussed below.